Community Carrying Capacity to Address Health System Referrals: A Networked Approach

As evidence emerges that health outcomes are determined by factors outside of the clinical health care delivery system, the nonprofit sector’s relevance to supporting positive health outcomes grows through the delivery of community-based services. This paper examines whether nonprofit community-based organizations have the capacity to absorb new referrals from clinical partners. The expectation of increasing referral activity raises concerns over limited nonprofit community carrying capacity. Using Social Network Analysis, we analyze the network of partners that make up two such community systems and determine the prominence of the referral function, the resources most frequently contributed to the network, dependence on primary revenue sources directly related to the clinical health care delivery system, and the community-based organizations’ perceptions of their financial stability and ability to rapidly respond to increasing referrals. The results suggest steps by which referrals from the clinical health care delivery system to community-based organizations can benefit both parties and health outcomes.