Considering the consequences of social instability within the health care system has become a public health priority. Each public hospital center in France is obliged to create a unit for welcoming impoverished and vulnerable people (Permanently Maintained Health Care Facilities). The university hospital in Nantes opened a socio-medical out-patient consultation service in November 1999 with the main objective being to bring these patients back into the usual ambulatory care system. The evaluation of the first few months of its operation reveals that one out of every two patients is a young person with a low-income and without any social protection. The possibilities of reorientation towards the regular care system are discussed.

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