European journal of internal medicine · 2026
When social issues become medical emergencies: Prevalence and patient characteristics of social emergency admissions in internal medicine.
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Baumgartner M A, Rutishauser F, Müller C, Boch M, Neuner-Jehle S, Hug B L, Beeler P E
Аннотация
BACKGROUND: Social Emergency Admissions (SEA) are unplanned hospitalisations due to acute social crises without medical indications. This study quantified and characterised SEA.
METHODS: We reviewed unplanned internal medicine admissions to 3 hospitals in Lucerne, Switzerland, in 2023. Admissions considered as SEA had ≥1 social stressor documented but no medical indication for hospitalisation. SEA were compared descriptively with other admissions.
RESULTS: Of 445 reviewed cases, 39 (8.8 %) were SEAs, corresponding to 6.7 % of all unplanned internal medicine admissions via emergency department. SEA could be categorised into 3 clusters: informal caregiver breakdown (22; 56.4 %), isolation/environmental neglect (14; 35.9 %), failure of formal care structures (3; 7.7 %). SEA patients were older (median 84 [interquartile range 75-88.5] vs. 72 [56.25-82] years), stayed longer (6 [4-9] vs. 4 [2-7] days), and more often received professional home support (35.9 % vs. 7.9 %) and care from relatives (53.8 % vs. 10.6 %). They were also more frequently multimorbid (≥2 comorbidities: 82.1 % vs. 64.3 %) and showed higher prevalence of electrolyte disorders (41.0 % vs. 19.5 %), weight loss (20.5 % vs. 5.2 %), alcohol abuse (17.9 % vs. 2.7 %), and dementia (17.9 % vs. 3.9 %).
CONCLUSION: This multicentre study provides the first quantitative assessment of SEA in internal medicine, with 6.7 % of unplanned admissions meeting a structured SEA definition and involving older, more multimorbid patients with longer hospital stays. SEA constitute a distinct subgroup of emergency admissions driven by identifiable social risk clusters rather than acute medical urgency.
METHODS: We reviewed unplanned internal medicine admissions to 3 hospitals in Lucerne, Switzerland, in 2023. Admissions considered as SEA had ≥1 social stressor documented but no medical indication for hospitalisation. SEA were compared descriptively with other admissions.
RESULTS: Of 445 reviewed cases, 39 (8.8 %) were SEAs, corresponding to 6.7 % of all unplanned internal medicine admissions via emergency department. SEA could be categorised into 3 clusters: informal caregiver breakdown (22; 56.4 %), isolation/environmental neglect (14; 35.9 %), failure of formal care structures (3; 7.7 %). SEA patients were older (median 84 [interquartile range 75-88.5] vs. 72 [56.25-82] years), stayed longer (6 [4-9] vs. 4 [2-7] days), and more often received professional home support (35.9 % vs. 7.9 %) and care from relatives (53.8 % vs. 10.6 %). They were also more frequently multimorbid (≥2 comorbidities: 82.1 % vs. 64.3 %) and showed higher prevalence of electrolyte disorders (41.0 % vs. 19.5 %), weight loss (20.5 % vs. 5.2 %), alcohol abuse (17.9 % vs. 2.7 %), and dementia (17.9 % vs. 3.9 %).
CONCLUSION: This multicentre study provides the first quantitative assessment of SEA in internal medicine, with 6.7 % of unplanned admissions meeting a structured SEA definition and involving older, more multimorbid patients with longer hospital stays. SEA constitute a distinct subgroup of emergency admissions driven by identifiable social risk clusters rather than acute medical urgency.