Ethical conflicts over access to services: patient effects and worker influence in home health.
A survey of home health social workers (N = 51) explored the effects on patients of ethical conflicts over access to services. The findings suggest that patients were as likely to be discharged or not receive services as they were to receive the services without paying a fee. Social workers rated themselves as moderately influential in the resolution of the conflict. Their influence was significantly correlated with patients more often receiving services and less often being discharged. Social work influence was enhanced by recognition of professional expertise and/or through informal networking within the agency. Implications for practice and education are discussed.
Egan
Marcia
M
College of Social Work, University of Tennessee, Memphis, TN 38163, USA.
Kadushin
Goldie
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D016265:Conflict of Interest; D003657:Decision Making / Q000941:ethics; D004995:Ethics, Professional; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics / Q000941:ethics* / Q000706:statistics & numerical data; D006699:Home Care Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008875:Middle Aged; D010361:Patients / Q000523:psychology; D036301:Qualitative Research; D040841:Resource Allocation / Q000191:economics / Q000941:ethics; D012947:Social Work / Q000191:economics / Q000941:ethics* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States