Dermatological consultation for poor patients: a medical social prospective study in Saint-Louis Hospital, Paris.

Introduction. The aim of our study was to evaluate the outcomes and the cos t of the dermatological consultation for poor and destitute patients, in Sa int-Louis Hospital. Patients and methods. We carried out a prospective study from May to Octobe r 1996. One hundred and eighty-nine patients (237 consultations) who had no social welfare, were examined. Results. They revealed that 82 p. 100 were male, 63.7 p. 100 were French, 1 3.9 p. 100 came from Maghreb, 9.7 p. 100 from Sub-Saharan Africa, 73 p. 100 were homeless and 25.7 p. 100 were alcoholic. The average age was around 3 7.6. The main medical disorders: scabies (56.5 p. 100), lice (22.4 p. 100) and cutaneous infections (7.2 p. 100) were related to the patients' living conditions and their social and economic situation. The other diseases obse rved were identical to the ones detected in regular health care centers. Co mplementary laboratories were necessary in 9.3 p. 100 consultations. Only 2 p. 100 of patients were admitted in Hospital. Local treatment was applied by nurses in 67 p. 100 of cases. Drugs were delivered free of charge by the Hospital's pharmacy in 64 p. 100 of cases. The cost of drugs was 83 FF per patient. The mean of duration of treatment was 10.5 days. Discussion. Social workers are a key element in helping the patients to rec over their social rights (49 p. 100 of patients have recovered social right s after 6 months). The frequency of skin diseases is higher in this population than in general population, especially in homeless persons. Access to health care is a pro blem of public health.