A National, Longitudinal Study Of The Changing Structure And Function Of Social Work Practice In Hospitals

Candyce Berger
School of Social Welfare
HSC-L2-093
Stony Brook University
Stony Brook NY 11794-8231
631-444-6909
FAX: 631-444-7565
csberger@notes.cc.sunysb.edu
 
Terry Mizrahi
School of Social Work
Hunter College
129 East 79th street
NY NY 10021
212-254-7574
FAX: 212-452-7085
tmizrahi@hunter.cuny.edu
 
Charles Robbins
School of Social Welfare
HSC-L2-093
Stony Brook University
Stony Brook NY 11794-8231
631-444-2139
FAX: 631-444-7565
crobbins@notes.cc.sunysb.edu
 
Michael Lewis
School of Social Welfare
HSC-L2-093
Stony Brook University
Stony Brook NY 11794-8231
631-444-3166
FAX: 631-444-7565
mlewis@notes.cc.sunysb.edu
 
Shelley Fleit
School of Social Welfare
HSC-L2-093
Stony Brook University
Stony Brook NY 11794-8231
631-689-9480
FAX: 631-444-7565
safleit@aol.com
This presentation reports on a national, longitudinal study of the changes impacting social work departments in hospital settings (fiscal years '92, '94, '96, '98).  A stratified random sample of 750 hospitals was drawn from the American Hospital Association membership list.  A self-administered questionnaire developed for use in the study was mailed to social work administrators/managers (42% - 46% response rate). Demographic data revealed that the samples were equivalent, and that response rates across the three data collection cycles was within 10% of the original sample.
 
Last year we presented data on changes within the hospital and its impact on social work staffing.  This presentation will focus on changes related to the structure and function of social work within the hospital setting.  Structural changes in social work services include shifts away from centralized structures, mergers with other departments, and decreases in social work management.  The number of directors with an MSW continued to decline, with commensurate growth in non-social work directors.  Directors increased spans of responsibility beyond management of a single social work department.  Significant changes in clinical supervision also occurred, with growth in the non-social work supervisor category.  While many of the management and clinical functions of social work staff remained relatively stable, significant changes did occur in key areas, such as ethics, discharge planning, pre-admission planning, and financial counseling.
 
The findings suggest that the changes impacting health care have had a dramatic effect on social work practice in the hospitals.  This report will include a detailed discussion of these and many other changes that have occurred since FY '92.  Logistic regression and survival analysis will be employed to examine factors associated with these changes over time.