Evidence-based support for community outreach worker programme in Rural British Columbia, Canada

摘要

Introduction: Community outreach workers (CWs) provide critical services to their community by connecting marginalised people to community and primary care services. The importance of CWs is overlooked in the current provincial primary health-care transformation due to perceived lack of evidence. This evaluation describes the efficacy of the CW programme in a rural British Columbian community. Methods: Capacity of the programme was determined by reviewing service and financial reports. Outcomes of the programme were analyzed from the electronic medical records and health systems data. Group discussions were conducted with providers, care team members and CWs for a deeper understanding of programme efficacy and impact. Results: For 64 h per month, CWs supported 15 clients, provided 28 visits and executed 10 referrals to community resources. The typical client was an adult of low socioeconomic status, unable to effectively organise themselves and navigate the health-care system and/or community resources, often as a result of undiag-nosed low mental or cognitive functioning. The programme positively impacted the health-care system by facilitating 142 attachments to providers, reducing client emergency department use by 41%, while marginally increasmg primary care services (6%), and supporting more appropriate emergency department visits. Conclusion: Clients enrolled in the programme did not fit into already defined services offered by the health authority. However, they required support to effectively function in their community. With the current health-care system transformation in British Columbia, it is imperative that the CW programme is recognised for its value to attract and maintain stable funding.