Social work interventions in emergency departments: Impact on patient outcomes and healthcare use

Abstract Background Emergency departments (EDs) are vital access points for individuals with acute health issues and vulnerable groups affected by social determinants such as homelessness, poverty, domestic violence, substance use, and mental health disorders. Social workers are crucial in addressing these factors and enhancing healthcare efficiency. However, evidence on their effectiveness in EDs remains limited. This study retrospectively evaluates the impact of social work interventions on patient outcomes and healthcare utilization. Methods We conducted a retrospective cohort study among patients aged ≥18 years consulted to the social work unit at Ankara Bilkent City Hospital ED between February 2019 and February 2024. Data from electronic records, social work assessments, and follow-up systems were analyzed. Demographic and clinical data, consultation reasons, interventions, and outcomes were assessed. Descriptive statistics and Chi-square tests were used (p < 0.05). Results A total of 714 patients were included (48.0% male; median age: 56 years). Main consultation reasons were housing needs (24.9%), domestic violence and sexual abuse (11.1%), substance use (2.7%), and psychosocial issues (28.0%). Interventions included psychosocial support (40.8%), resource referral (24.4%), crisis intervention (25.1%), and family contact (25.1%). Patients receiving interventions had lower hospitalization rates and more organized discharges (p < 0.05). Incomplete assessments were more frequent during night shifts (p < 0.001). Conclusions Social work interventions in EDs enhance patient care quality and optimize healthcare utilization, particularly in managing housing instability, violence, psychosocial issues, and addiction. Strengthening 24-hour coverage, multidisciplinary integration, and standardized models are key strategies for improving outcomes. Further research is needed to evaluate long-term effects. Key messages • Social work interventions improve emergency department care quality and healthcare efficiency. • Expanding 24-hour social work services and integration enhances patient outcomes.