Abstract

BackgroundThis study seeks to explore how social workers have perceived and experienced a medical home model for children and adolescents in out-of-home care in Uppsala County, Sweden.MethodA qualitative explorative study was conducted, which involved ten semi-structured individual telephone interviews with social workers. The study sample included employees within the social service, working in a specialised case unit who had experience of referring children and/or adolescents to the medical home model called Hälsofam. Data were analysed inductively using thematic analysis.ResultsThe findings of the current study indicated that working with Hälsofam has offered social workers a way into the health care sector and an active collaborative working situation, with focus on organised work across the ‘silos’ of care services. However, the findings raised the question of whether or not all children and adolescents have the same possibility to receive care from Hälsofam.ConclusionThe findings indicated that the Hälsofam model had a positive impact on the interrelations between the social service and the health care sector. Yet, findings showed that personal views of the social worker and the societal situation in which they operate create limitations for providing care for every child and adolescent. This study adds to the extant literature for it addresses the limitations within the work of children and adolescents in out-of-home care.

Highlights

  • This study seeks to explore how social workers have perceived and experienced a medical home model for children and adolescents in out-of-home care in Uppsala County, Sweden

  • The findings indicated that the Hälsofam model had a positive impact on the interrelations between the social service and the health care sector

  • This study adds to the extant literature for it addresses the limitations within the work of children and adolescents in out-of-home care

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Summary

Introduction

This study seeks to explore how social workers have perceived and experienced a medical home model for children and adolescents in out-of-home care in Uppsala County, Sweden. In Sweden, outcomes for children in out-of-home care (OHC) have been disappointing [1]. To place a child or Johansson et al BMC Health Services Research (2021) 21:804 adolescent in OHC according to Act SFS, 2001:453 [13], the social service is obliged to have an active investigation within the family and a consensual agreement between with all concerning parties. Children and adolescents who receive care according to SFS, 1990:52 [14] are in an acute state, which requires an immediate placement in OHC and no consensual agreement. In 2018, 77% of the OHC placements were voluntary care and 23% were compulsory care [11]

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