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Emergency departments as the health safety nets of society: a descriptive and multicenter analysis of social worker support in the emergency room

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dc.contributor.author Selby, Sasha
dc.contributor.author Wang, Dongmei
dc.contributor.author Murray, Eoin
dc.contributor.author Lang, Eddie
dc.date.accessioned 2018-10-03T08:39:14Z
dc.date.available 2018-10-03T08:39:14Z
dc.date.issued 2018
dc.identifier.uri http://hdl.handle.net/10344/7188
dc.description peer-reviewed en_US
dc.description.abstract Introduction Social Work (SW) referrals made in the emergency department (ED) highlight the weaknesses in the existing support system for vulnerable and disadvantaged patients. SW personnel play a pivotal role in some EDs but are not integrated into the team in several jurisdictions. Our objective was to provide a detailed description of the need for SW support in the ED setting by describing SW consultation patterns in an urban ED location. Methods A three-year analysis of ED SW referrals made through a network of four acute care hospitals serving a city population of 1.2 million inhabitants where social workers operate from 8 a.m. to 10 p.m. The study design was descriptive reporting proportions. The descriptors of interest were the types of ED patients receiving SW consultations and the reasons for patient referral to the SW Department. Results During the study period, there were 46,970 SW consultations, representing 8.02% of the 572,804 patients who visited the ED across Calgary, yielding 42.9 referrals per day to social workers through the ED. Consultations for domestic violence were three times more prevalent for women (6% of referrals). However, domestic violence consultations were still an active issue for men (1.9%). Comparisons by age group yielded illness adjustments (15.3%), discharge planning (31.2%), and legal decision making (23.9%) as the most common reasons for referral of patients over 75 years old; 92.8% of patients over 75 years were admitted following the SW consultation. Reasons for deferral of patients under 30 years of age were illness adjustments (12.2%), discharge planning (16.4 %), and legal decision making (1.4%); 57.3% of patients under 30 years were admitted following the consultation. Addiction/drug use and homelessness were more common in those under the age of 30, comprising 24.1% and 15.4% of the SW referrals, respectively, compared to 1.6% and 0.4% of referrals for those over age 75, respectively. Conclusions The demand for SW support is significant and complex in these large urban EDs. However, the impact on patient care and resource use is substantial, and the data indicates that SW en_US
dc.language.iso eng en_US
dc.publisher Cureus, Inc en_US
dc.relation.ispartofseries Cureus;10(9): e3247
dc.relation.uri http://dx.doi.org/10.7759/cureus.3247
dc.subject social work en_US
dc.subject emergency medicine en_US
dc.subject safety net en_US
dc.subject analysis en_US
dc.subject emergency department (ed) en_US
dc.subject multidisciplinary care en_US
dc.title Emergency departments as the health safety nets of society: a descriptive and multicenter analysis of social worker support in the emergency room en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.7759/cureus.3247
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US


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