Early social intervention in the emergency department

To assess the usefulness of an early medical social intervention conducted by a specially oriented medical social workers stationed in the Emergency Department.

Prospective study during a 2-month reference period, in a 900-bed inner-city teaching hospital that has approximatively 30,000 emergency department visits annually, providing health care facilities for a metropolitan area with a population of 230,000.

Among 6,000 patients presenting to the emergency department during the study, 72 were found to require social intervention (1.2% of all emergency department visits, 6.85% of admissions to the hospital). Social intervention consisted of telephone calls (89%), correspondence by letters (26.5%), counsel and advice (23.5%), out-hospital intervention (14%) and resulted in: house-keeping help (34.5%) or transferal to nursing homes or nursing hospitals (28%) of elderly patients; aid to homeless and socially disadvantaged people, such as transferal to homing city shelters, clothing supply, etc., allowing extra hospital maintenance (23.5%); regularization of health insurance affiliation (10%); aid in various other social situations (22%).

An early medical social intervention in the emergency department resulted in alternatives to hospital admission for a high proportion of patients (82%).