title: When the bough breaks: provider-initiated comprehensive care is more effective and less expensive for sole-support parents on social assistance.
abstract: This 5-year study conducted in Ontario, Canada is designed to assess the effects and expense of adding a mix of provider-initiated interventions to the health and social services typically used in a self-directed manner by sole-support parents and their children receiving social assistance in a national system of health and social insurance. Results from a 2-year interim analysis show that providing social assistance families with proactive comprehensive care (health promotion, employment retraining, and recreation activities for children) compared to allowing families to fend for themselves in a self-directed manner, results in 15% more exits from social assistance within 1 year and substantial savings to society in terms of social assistance payouts. It is no more expensive to provide health and social services in a comprehensive fashion, and equivalent reductions in parent mood disorder and child behavior disorders, as well as equivalent increases in parent social adjustment and child competence levels were also observed. This study presents clear evidence that providing comprehensive care to social assistance recipients produces tremendous short- and long-term financial gains and societal benefits.
authors.affiliation: System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Hamilton, Ont., Canada. browneg@mcmaster.ca
authors.forename: G
authors.initials: G
authors.lastname: Browne
authors.forename: C
authors.initials: C
authors.lastname: Byrne
authors.forename: J
authors.initials: J
authors.lastname: Roberts
authors.forename: A
authors.initials: A
authors.lastname: Gafni
authors.forename: S
authors.initials: S
authors.lastname: Whittaker
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003191:Comprehensive Health Care / Q000191:economics* / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009864:Ontario; D011632:Public Assistance / Q000191:economics; D016032:Randomized Controlled Trials as Topic; D012917:Social Adjustment; D012959:Socioeconomic Factors; D016896:Treatment Outcome