Objective: A prospective clinical trial was conducted to measure the effectiveness and cost-benefit of social work clinical practice on a multi-organ transplant program. Method: Recipient financial, clinical, and quality-of-life data were collected for patients who received organ transplants in 1995 (N= 105) at Integris Oklahoma Transplantation Institute. Results: The income produced for the organization exceeded the cost of providing social work services but demonstrated only a limited ability to reduce the future cost exposure for the program. Prioritized clinical practice identified those at greatest need of social work services, provided the framework for interventions and reporting of outcomes, while maintaining a patient's quality-of-life. Conclusions: The outcome-based clinical research has resulted in policies and clinical practice patterns that are both beneficial for transplant patients and meet the economic and clinical mandates of the employing organization.
Get full access to this article
View all access options for this article.
References
1.
Appleby, C. (1996). True values: Ethical decision-making and managed care aren't mutually exclusive. Hospital Health Network, 70, 21-22, 26-26.
2.
Bracht, N. F. (1978). Social work in health care: A guide to professional practice. In N. F. Bracht (Ed.), The scope and historical development of social work, 1900-1975 (pp. 3-18). New York: Haworth.
3.
Cooper, D. K. C., Samara, E., Mieles, L., Merhav, H., Imes, N., & Van-Thiel, D. (1994). Survival following organ transplantation in an Oklahoma institution, 1985-1993. Journal of the Oklahoma State Medical Association, 87, 506-508.
4.
Dew, M. A., Roth, L. H., Thompson, M. E., Kormos, R. L., & Griffith, B.P. (1996). Medical compliance and its predictors in the first year after heart transplantation. Journal of Heart and Lung Transplantation, 15, 631-645.
5.
Ell, K. (1996). Social work and health care practice policy: A psychosocial research agenda. Social Work, 41, 583-592.
6.
Evans, R. W., Manninen, D. L., Overcast, T. D. & et al. (1984). National heart transplatation study (final report). Seattle, WA: Batelle Human Affairs Research Center.
7.
Ferrans, C. S. (1990). Development of a quality of life index for patients with cancer. Oncology Nursing Forum, 17, 15-21.
8.
Gier, M., Levick, M., & Blanzia, P. (1988). Stress reduction with heart transplant patients and their families: A multidisciplinary approach. Journal of Heart Transplantation, 7, 342-347.
9.
Hauser, M. L., Williams, J., Strong, M., Ganza, M., & Hathaway, D. (1991). Predicted and actual quality of life changes following renal transplantation. ANNA, 18, 295-305.
10.
Kayser, K., Hansen, P., & Groves, A. (1995). Evaluating social work practice in a medical setting: How do we meet the challenges of a rapidly changing system?Research on Social Work Practice, 5, 485-500.
11.
Lough, M. E. (1988). Quality of life for heart transplant recipients. Journal of Cardiovascular Nursing, 2, 11-22.
12.
Lough, M. E., Lindsey, A. M., Shinn, J. A., & Stotts, N. A. (1985). Life satisfaction following heart transplantation. Journal of Heart Transplantation, 4, 446-449.
13.
Olbrisch, M. E., & Levenson, J. L. (1991). Psychosocial evaluation of heart transplant candidates: An international survey of process, criteria, and outcomes. Journal of Heart and Lung Transplantation, 10, 948-955.
14.
Paris, W. (1990). Medico-social aspects. In D. K. C. Cooper & D. Novitzky (Eds.), Transplantation and replacement of thoracic organs (pp. 223-226). London: Kluwer Academic.
15.
Paris, W., Harrison, J., Diercks, M., & Jones, J. (1997). The new health insurance law and its potential impact on transplant programs and recipients. Transplant Coordination, 7, 157-158.
16.
Paris, W., Muchmore, J., Pribil, A., Zuhdi, N., & Cooper, D. K. C. (1994). Study of the relative incidences of psychosocial factors before and after heart transplantation and the influence of post-transplant psychosocial factors on heart transplant outcome. Journal of Heart and Lung Transplantation, 13, 424-432.
17.
Paris, W., Tebow, S., Dahr, A., & Cooper, D. K. C. (1997). Returning to work after heart transplantation—A replication. Research on Social Work Practice, 7, 370-377.
18.
Paris, W., Thompson, S., Brawner, S., Penido, M., Bright, J., & Robertson, C. (1996). Medico-social aspects. In D. K. C. Cooper, L. W. Miller, G. A. Patterson (Eds.), The transplantation and replacement of thoracic organs (Vol. 2, pp. 137-140). London: Kluwer Academic.
19.
Paris, W., Woodbury, A., Thompson, S., Levick, M., Nothegger, S., & Hutkin-Slade, L. (1993). Return to work post-transplantation. Journal of Heart and Lung Transplantation, 12, 46-53.
20.
Ponto, J. M., & Berg, W. (1992). Social work services in the emergency department: A cost-benefit analysis of an extended coverage program. Health & Social Work, 17, 66-73.
21.
Price, R. H. (1986). Foreword. In E. J. Thomas (Ed.), Designing interventions for the helping professions (pp. 7-8). Beverly Hills, CA: Sage.
22.
Reimbursement of independent organ procurement organizations and histocompatibility laboratories,42 C.F.R. No. 413.178 (1990).
23.
Scott, J., Moon, C. A., Blacker, C. V., & Thomas, J. M. (1994). Edinburgh primary care depression study. British Journal of Psychiatry, 164, 410-415.
24.
Shapiro, P. A. (1990). Life after heart transplantation. Progress in Cardiovascular Disease, 32, 405-418.
25.
Shapiro, P. A., Williams, D. L., Foray, A. T., Gelman, I. S., Wukich, N., & Sciacca, R. (1995). Psychosocial evaluation and prediction of compliance problems and morbidity after heart transplantation. Transplantation, 60, 1462-1466.
26.
Sisson, S., Tripp, J., Paris, W., Cooper, D. K. C., & Zuhdi, N. (1994). Medication noncompliance and its relationship to financial factors after heart transplantation (letter). Journal of Heart and Lung Transplantation, 13, 930-930.
27.
Suszycki, L. H. (1986). Social work groups on a heart transplant program. Journal of Heart Transplantation, 5, 166-170.
28.
Tazelaar, S. L., Prieto, M., Lake, K. D., & Emery, R. W. (1992). Heart transplantation in high-risk psychosocial patients (abstract). Journal of Heart and Lung Transplantation, 11, 207-207.
29.
Young, K. J., & Longman, A. J. (1983). Quality of life and persons with melanoma: A pilot study. Cancer Nursing, 6, 219-225.
