1. Social Work In Health Care
Chapter 10

2. Introduction Social services are needed in a hospital because:
All of the patient’s needs are important.
Patients require financial help.
Social service workers create important links to the community.
The American Hospital Association reports they have social work services in 75% of their hospitals.
Medicine and social work joined hands for the first time at Massachusetts General Hospital in 1905.

3. Introduction
15 % of the United States’ gross national product was spent on health care in l998.
In l986 the number of health care social workers was 50,000.
The majority of health care social workers practice in long-term care hospitals.

4. Definition of Social Work in Health Care
Social work in health care settings is practiced in collaboration with medicine and also with public health programs.
Social work addresses itself to illness brought about by or related to social and environmental stresses that result in failures in social functioning and social relationships.

5. HMO and Social Work
One of the most important developments for social workers in health care was the Health Maintenance Organization Act of l973.
Originally the HMO Act required the provision of social services in HMO’s.
This provision was later eliminated by several subsequent congressional actions.

6. Social Work Services
Social workers in health care services use the problem solving method in assisting individuals, groups and communities in solving personal and family health problems.
Social work is involved at various levels of prevention:
Primary – health education, encouraging immunizations, good mental health practice in families, prenatal and postnatal care.
Secondary – early screening programs for detection of disease, checkups, encouraging treatment.
Tertiary or rehabilitation – preventing further deterioration of a disease or problem.

7. The Meaning of Illness
Illness encompasses medical, social, economic and even spiritual components.
Broadly speaking, illness – impaired role function – may result from factors not wholly organic, but social, psychological, cultural, and economic.
Illness can result in:
Forced dependency
Disorganization of family
Loss of self-respect
Feelings of helplessness

8. Meaning of Illness
The increase in chronic disease among Americans has literally changed the meaning of illness for a great many people.
People have to live with chronic disease, adjust to pain, change habits- diet, quit smoking, exercise, and change employment.

9. Meaning of Illness
With chronic conditions – arthritis, heart disease, AIDS, some cancers – the patient must be a partner in the care of the disease, in its prevention and deterioration.
By 1991 conservative estimates were that 1,100,000 people around the globe had developed AIDS.
Social work comes into the picture in helping the patient to adjust, to accept medical regimens, and to relate to the health complex involved in the broadened care aspects of chronic disease.

10. The Role of Social Work in Health Care
The social workers can be most valuable at the time the patient has been admitted or discharged from a hospital or during follow-up care once leaving the hospital.
One purpose of social work is to support and strengthen family life.
The social worker makes use of existing services through referrals or assists in mobilizing the untapped potential of the community to prevent illness or to restore the sick and disabled to health and usefulness.

11. The Future of Social Work in the Health Care Services
In l998 it was estimated that the number of uninsured Americans was one out of four.
The health care system of the United States is more costly than Canada, Germany or Japan.
One in five American children has no public or private health insurance coverage.
One in four black children and one in three Hispanic children have no coverage.