Case Management for Frequent Users of the Emergency Department

"Furnish specific assistance and to provide referrals for the patients:~* If the social determinants are not adequate, the team will lend assistance for obtaining income entitlements, health insurance coverage if eligible, stable housing, schooling for children, etc.~* If there are mental disturbances, the team will refer to mental health departments inside the hospital, and if necessary, to a psychiatrist, psychologist or general practitioner (GP) out in the community.~* If the patient presents risk behaviors, the team will refer to substance abuse services and links to community services in order to maintain continuity of care.~* In case of somatic problems, the team will find a new GP or make contact with the previous provider, contingent on the patient's consent."