title: Emergency room outreach to chronically addicted individuals. A pilot study.
abstract: There is a dearth of literature describing the treatment needs of substance-abusing or chronically mentally ill homeless individuals who frequently utilize emergency medical services. This homeless subset represents a discrete population in the larger homeless community. We describe a pilot program, supported by local county public funds, and conducted by a local nonprofit social work agency, which was designed to provide intensive case management services to such a population. Outreach and case management activities resulted in linking clients to a broad range of entitlements and community services. Among those receiving outreach and case management services (n = 10), emergency services decreased by 58% in the year following referral compared to the year before (p <.03). Emergency services for the purpose of this study are defined as ambulance response and transport followed by emergency room admission and treatment. Those in a comparable control group (n = 8) showed no decrease in emergency service use. These results suggest that such community-based outreach programs can significantly improve patient outcome and provide substantial cost savings for local governments and hospitals.
authors.affiliation: Michigan Ability Partners, Ann Arbor 48108, USA.
authors.forename: G
authors.initials: G
authors.lastname: Witbeck
authors.forename: S
authors.initials: S
authors.lastname: Hornfeld
authors.forename: G W
authors.initials: GW
authors.lastname: Dalack
mesh_terms: D000328:Adult; D000368:Aged; D019090:Case Management / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D004636:Emergency Service, Hospital / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010865:Pilot Projects; D012041:Regional Medical Programs / Q000458:organization & administration; D019966:Substance-Related Disorders / Q000191:economics / Q000534:rehabilitation*