EMERGENCY ROOMS: Could Assume a Social Welfare Role
The logical potential of hospital emergency departments to act in a social welfare role has gone unexplored, according to an article in the March issue of the Annals of Emergency Medicine. Dr. James Gordon of the University of Michigan-Ann Arbor notes that with 90 million patient visits to U.S. emergency departments each year, the ER is "a logical site ... for the identification of basic social needs and the extension of existing community resources." As the "only component of the entire social welfare system that is protected by law," Gordon suggests that ERs could create a "social triage" center to identify patients with "pressing social needs." As an outpost of the local welfare agency, the ER could screen patients with questions "built into the standard triage history or registration interview," such as: "Can you pay your rent? Are your utilities working? Do you have enough food to eat? Can you get to the doctor? Can you afford medicines?" He asks, "If a poor family brings a sick child to the [ER] and reports a lack of food, then why shouldn't food stamp eligibility be determined, or at least discussed, on the spot?" Patients identified as needing assistance could be shuttled from the ER to a social triage center for a more complete evaluation. Funding for the effort, explains Gordon, could be shouldered by the government, health systems and local charities together as a public-private partnership (Gordon, March 1999 issue). While noting that most communities already offer charitable services, Gordon asserts that "the coordination of such services can be more of a problem that the availability of the services themselves." He says, "The hospital and its [ER], holding ever more prominent positions in a society increasingly driven by health care, are well-suited to help evaluate coordinated social care as an integral part of total community health" (Reuters Health, 3/1).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.