Assessing the implementation and impact of a social prescribing protocol in primary care

Abstract

Background: Social prescribing allows clinicians to refer people to resources or activities in their community to improve their abilities and health. Implementation of social prescribing is growing. However, there is not enough evidence on several related issues. The aim of study was to analyse the implementation of the asset-based model in the primary care teams in Aragón and to describe the profile of people who benefit most and are most satisfied with social prescribing.

Methods: It is an analytical observational study in the 123 primary healthcare teams of Aragon from September2018 to December2022. The data were obtained from Electronical Health Record, checked and cleaned. A descriptive analysis was performed for qualitative and mean and standard deviation for quantitative variables. To analyse the associations between attendance, satisfaction, and improvement with all variables, several analyses were conducted using different methods. Finally, a cluster analysis was developed with the most benefited and satisfied people.

Results: During the study period, 2,735 asset recommendations were made to 2,578 different people and 1,050 follow-ups to 552. There was an increase in the use of the protocol over time, except during the COVID pandemic. Most recommendations were made to women (73.3%-2,006). The average age was 65. There were more referrals in the smallest places (3.11 referrals/1000inhabitants). The most frequent linked health issues were psychological problems (572 - 20.9%). Physical skills were the abilities that professionals most tried to promote (28.4-1,709). In the follow-ups, the 81.4%(373) reported attending to the asset regularly. There were differences according to age and health problems. The average of improvement was 3.87/5 with differences by age, municipality size and health problems. For satisfaction, the average was 4.57/5 with differences by age and health problems. The lowest level of improvement and satisfaction was found for social problems. The cluster analysis highlighted several groups. Three profiles were distinguished in terms of high improvement and four of high satisfaction. In both cases, the variables related to areas for enhancement primarily defined the profiles.

Conclusions: It is necessary to continue research with strong methodological and complementary approaches. This manuscript is optimistic about the use and impact of the social prescription in primary health care.

Keywords: Community health services; Community networks; Effectiveness; Empowerment for health; Health promotion; Intersectoral collaboration; Patient satisfaction; Primary health care; Social prescribing.

Fig. 1

People involved in the different phases of the study

Fig. 2

Evolution of the number of social prescriptions

Fig. 3

Factor map of the clusters differentiated in people with high improvement Figure 3. Dimension 1 contrasts the presence of the spheres relational and social skills, emotional skills, cognitive skills, self-care, others vs. the absence of such spheres. Dimension 2 contrasts the absence of the physical activity sphere vs. its presence

Fig. 4

Factor map of the clusters differentiated in people with high satisfaction Figure 4. Dimension 1 contrasts the presence of the spheres relational and social skills, emotional skills, cognitive skills, self-care, others vs. the absence of such spheres. Dimension 2 contrasts the absence of the physical activity sphere vs. its presence