Examining the impact of two patient navigation models within a social prescribing program on self-reported health service utilization and health-related quality of life

Abstract

Background: Social prescribing programs have shown promise for addressing the healthcare system fragmentation and the negative impact of certain social determinants of health. They entail primary care providers referring patients with unmet health or social needs to community resources, a process that is mediated by a lay navigator, who assists patients in identifying barriers and facilitating access to the appropriate resources. Although Ontario 211 and the Access to Resources in the Community (ARC) intervention both utilize lay navigators to assist their patients, the former provides informational services to its patients, whereas the latter offers more comprehensive and reoccurring support to patients.

Study Objective: This study compared the impact of both navigation models within a social prescribing program setting on patient self-reported health service utilization and health-related quality of life.

Methods: A secondary analysis was conducted using data collected in 2018/19 during the randomized control trial (RCT) comparing ARC and Ontario 211 navigation. Three hundred and twenty-six patients were enrolled in the study, and 237 patients completed the post-intervention questionnaire. Participants were adults who had identified an unmet health or social need and frequented a primary care provider. Health service utilization outcomes included the number of emergency department (ED) visits and hospitalizations, while the health-related quality of life was assessed with the validated Veterans RAND 12 questionnaire. Unadjusted and adjusted regression analyses were conducted to compare outcomes between both navigation models, controlling for socio-demographic characteristics.

Results: Although none of the results reached statistical significance, participants assigned to the ARC navigation intervention had an apparent higher odds of ED visits and modestly improved physical quality of life yet had relatively similar odds of hospitalization and improvement in mental quality of life compared to those in the Ontario 211 arm.

Conclusion: Despite not demonstrating statistically significant associations, the results provide insight into the emerging field of social prescribing in Canada. In today’s political and economic landscape, with a healthcare system focused on addressing social determinants of health, there remains an ongoing need for innovative evaluations of preventative interventions. While effects may not always be observed immediately, as in these findings, with continued research, social prescribing programs show potential for leading the way to equitable care.