Abstract

Introduction: Many psychiatric patients in urban areas of the US receive Supplemental Security Income (SSI). It is conceivable that depletion of funds triggers for some patients a visit to emergency room (ER). If this was the case, it could be expected to register an increase numbers of visits of SSI recipients towards the end of the payment cycle. If this is not the case, the suspicion that admission to the hospital might also provide a secondary gain, should be remove as a consideration, so that patients can receive an unbiased assessment. Methods: Charts of patient’s visits at the psychiatric ER of Thomas Jefferson University Hospital in Philadelphia were reviewed. The relationship between the number of days after receiving the benefits payment and time of presentation to the ER was analyzed. Homelessness status and the presence of a positive drug test were also considered. Results: 274/1007 of patients who visited the ER visits during 2018 were recipients of SSI. No relationship was found between visit time and days elapsed since last benefits check. The interval between receiving benefits and visiting the ER had no relationship to homelessness status (p=0.9271) or the presence of a positive drug screen (p=0.0752) Conclusion: There was no increase in ER visits at the end of the payment cycle to suggest that exhausted funds played a role, either as a psychosocial stressor or as a motivation for the secondary gain. Despite the limitations of this study, denying admission to a patient based on suspicions of secondary gains should be reconsider