The urban health care clinic and its substance abuse population

The effect of large numbers of patients with a history of substance abuse upon a health care system is rarely considered, nor is the health care system's response to such a clientele ever assessed. In this preliminary study, the collective effect of large numbers of substance abuse patients upon a clinic serving the urban poor and homeless is evaluated. The study examines the types of problems patients present to the clinic and the health care response, in terms of diagnoses and treatment plans, provided by the clinic. Using a random sample of 163 medical records, a retrospective analysis of reasons for visit, diagnoses and treatment plans was performed. Results indicated that patients with a history of substance abuse were more likely to present with chronic complaints and were not frequent return visitors to the clinic. No significant differences in either diagnoses or treatment plans for patients with a history of substance abuse were discovered. The implication of these results for health services provided to urban poor and homeless patients with histories of substance abuse was considered, as were reasons for the type of system response indicated by the results obtained.