Patients attending A&E because of social problems – such as homelessness and alcoholism – cost United Lincolnshire Hospitals Trust hundreds of thousands of pounds during the first year of the coronavirus pandemic, figures show.
Charity Crisis said homelessness causes severe inequalities in care, with health issues often going untreated until a critical point.
And figures from NHS Digital shows the cost to the health service of treating patients with social issues across England has almost doubled over just two years.
Data shows roughly 530 emergency care admissions to United Lincolnshire Hospitals NHS Trust had a diagnosis of "social problems (including chronic alcoholism and homelessness)" in 2020-21.
It cost the trust £225,356 to treat patients with this diagnosis over the period.
The number of admissions fell from 560 the year before, but the cost increased from £180,649.
In 2018-19 – the first year such figures were recorded – there were roughly 815 patients admitted with this diagnosis, at a cost of £223,047.
The figures also cover a range of other categories – including nutritional disorder, safeguarding abuse, social problems in schools and poor social circumstances – with the diagnosis made by the clinician responsible for the patient attending A&E.
More than 50,500 patients were admitted to NHS hospitals, minor injury units and walk-in centres with issues such as these across England last year – up slightly from 48,300 the year before and 48,700 in 2018-19.
But the cost to the NHS (£21.1 million) jumped from £13.5 million in 2019-20, and almost doubled from £11.8 million just two years prior.
The Institute of Alcohol Studies said one explanation for this rise could be that people with social problems in 2020-21 had more severe issues when they arrived at emergency departments.
An IAS spokesman said there were increases in higher risk drinking, alcohol liver disease emergency admissions and alcohol-specific deaths that year, but warned any trends during the pandemic are difficult to interpret.
Dr Alison Giles, chief executive of the IAS, said it is "shocking" to see how much the NHS spends on treating issues including alcohol harm, but said measures such as minimum unit pricing would help bring this down.
She added: "These could be introduced as part of a Covid-19 recovery plan, otherwise we will almost certainly continue to see a rise in admissions and costs, as well as deaths.”
Matt Downie, chief executive of Crisis, said something as simple as lack of ID can make going to a GP impossible for people experiencing homelessness – meaning health issues often are not addressed until a critical point.
He added: "The fact that people are accessing treatment is positive, but the focus must be on getting tailored health care support early on."
He said recent NICE guidelines – which call for specialist services to meet the complex needs of people who are homeless – must be implemented.
In terms of cost, social problems was ranked 29th out of the 38 different types of emergency care diagnosis listed at United Lincolnshire Hospitals Trust.
It was responsible for less than 1% of the trust's £45.1 million total costs.
The highest amount was spent on treating patients with gastrointestinal conditions – £4.7 million (10%).