Emergency room outreach to chronically addicted individuals. A pilot study

J Subst Abuse Treat. 2000 Jul;19(1):39-43. doi: 10.1016/s0740-5472(99)00090-2.


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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Case Management / economics
  • Case Management / organization & administration*
  • Case Management / statistics & numerical data
  • Chronic Disease
  • Cost-Benefit Analysis
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Ill-Housed Persons / statistics & numerical data*
  • Male
  • Michigan
  • Middle Aged
  • Pilot Projects
  • Regional Medical Programs / organization & administration
  • Substance-Related Disorders / economics
  • Substance-Related Disorders / rehabilitation*