[Dermatologic consultation in a precarious situation: a prospective medical and social study at the Hôpital Saint-Louis in Paris].
BACKGROUND
The aim of our study was to evaluate the outcomes and the cost of the dermatological consultation for poor and destitute patients, in Saint-Louis Hospital.


METHODS
We carried out a prospective study from May to October 1996. One hundred and eighty-nine patients (237 consultations) who had no social welfare, were examined.


RESULTS
They revealed that 82 p. 100 were male, 63.7 p. 100 were French, 13.9 p. 100 came from Maghreb, 9.7 p. 100 from Sub-Saharan Africa, 73 p. 100 were homeless and 25.7 p. 100 were alcoholic. The average age was around 37.6. The main medical disorders: scabies (56.5 p. 100), lice (22.4 p. 100) and cutaneous infections (7.2 p. 100) were related to the patients' living conditions and their social and economic situation. The other diseases observed were identical to the ones detected in regular health care centers. Complementary laboratories were necessary in 9.3 p. 100 consultations. Only 2 p. 100 of patients were admitted in Hospital. Local treatment was applied by nurses in 67 p. 100 of cases. Drugs were delivered free of charge by the Hospital's pharmacy in 64 p. 100 of cases. The cost of drugs was 83 FF per patient. The mean of duration of treatment was 10.5 days.


CONCLUSIONS
Social workers are a key element in helping the patients to recover their social rights (49 p. 100 of patients have recovered social rights after 6 months). The frequency of skin diseases is higher in this population than in general population, especially in homeless persons. Access to health care is a problem of public health.
Arfi
C
C
Service de Dermatologie, Hôpital Saint-Louis, Paris.
Dehen
L
L
Bénassaïa
E
E
Faure
P
P
Farge
D
D
Morel
P
P
Dubertret
L
L
D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D000352:Africa, Northern / Q000208:ethnology; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology; D016527:Drug Costs; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D017048:Health Care Costs; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D010373:Lice Infestations / Q000453:epidemiology; D008297:Male; D010297:Paris / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010607:Pharmacy Service, Hospital / Q000191:economics; D011203:Poverty / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012532:Scabies / Q000453:epidemiology; D012737:Sex Factors; D012871:Skin Diseases / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000451:nursing; D012874:Skin Diseases, Infectious / Q000453:epidemiology; D012947:Social Work / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D016896:Treatment Outcome