Heavy users of an emergency department: psycho-social and medical characteristics, other health care contacts and the effect of a hospital social worker intervention.
A small proportion of the patients coming to emergency departments of general hospitals account for a substantial share of the department's resources by making repeated visits. Repeater behaviour is a complex product of many, sometimes concurrent factors. This study has focused on the medical and psycho-social factors. A group of patients with repeated visits to an emergency department of a middle-sized Stockholm hospital was studied in 1980. The repeater group had a heavier load of psycho-social problems than the source population. The repeater behaviour profile included: feeling of loneliness, living alone, contacts with social agency, disability pension, high sick absenteeism from work and alcoholism. The repeater group had numerous contacts with health-care providers outside the emergency department. Some of the repeaters needed and received help by a social hospital worker. Of those that received such help 80% significantly decreased their emergency department visiting rate.
D000223:Adaptation, Psychological; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006801:Humans; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012931:Social Environment; D012948:Social Work Department, Hospital / Q000706:statistics & numerical data*; D012949:Social Work, Psychiatric / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013548:Sweden