Health care for released prisoners prevents high emergency department use

By Helen Dodson
Health care for released prisoners prevents high emergency department use

Expediting primary health care for chronically ill inmates soon after release from prison results in fewer visits to hospital emergency departments, a Yale study has found. The study is published in the American Journal of Public Health.

The United States has the highest incarceration rate in the world, with over a million individuals in prison at any given time. These prisoners suffer high rates of medical, psychiatric, and substance abuse problems. Although they receive care while in prison, the 700,000 prisoners that are released each year receive little coordination of care between prison and community health systems, and face very poor . Left on their own, they frequently use hospital emergency departments as their regular source of care.

The researchers compared two interventions designed to improve primary care engagement in this population: Transitions Clinic, a primary care-based care management program with a formerly incarcerated community health worker who specializes in the care of released prisoners, versus the control arm of the study which provided expedited but less specialized primary care.

They studied 200 recently released prisoners with . The researchers found that while both groups had similar rates of primary care utilization, participants in the Transitions Clinic had a 51% lower rate of emergency department visits in 12 months of follow-up.

First author Dr. Emily A. Wang, assistant professor at Yale School of Medicine, said, “Our study shows that chronically ill patients who usually bypass the system will engage and remain in primary care if efforts are made to provide them patient-centered services immediately after leaving prison. In addition, providing them with a management program tailored to their needs will reduce emergency department utilization.”

Yale, in partnership with the San Francisco Community College District and University of California-San Francisco, has received a $6.8 million grant from the Center for Medicare & Medicaid Innovation for the expansion of the national Transitions Clinic Network (also funded by the Langeloth Foundation). Former prisoners will be trained as community health workers, giving them an opportunity to overcome the stigma of incarceration, leverage their experiences to gain employment, and give back to their communities.

Other authors are Dr. Clemens Hong, of Massachusetts General Hospital; Dr. Shira Shavit, of University of California-San Francisco, executive director of Transitions Clinic Network; Ronald Sanders of Transitions Clinic at Southeast Health Center in San Francisco; Eric Kessell and Dr. Margot B. Kushel of San Francisco General Hospital.

The intervention and study were supported by the San Francisco Foundation, the California Endowment, the California Wellness Foundation, California Policy Research Center, and the San Francisco Department of Health. Wang was also supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health.

add to favorites email to friend print save as pdf

Related Stories

Care for prisoners will improve public health

Nov 19, 2010

In a comprehensive global survey, researchers in Texas and England have concluded that improving the mental and physical health of inmates will improve public health.

Recommended for you

The hunt for botanicals

Dec 19, 2014

Herbal medicine can be a double-edged sword and should be more rigorously investigated for both its beneficial and harmful effects, say researchers writing in a special supplement of Science.

Mozambique decriminalises abortion to stem maternal deaths

Dec 19, 2014

Mozambique has passed a law permitting women to terminate unwanted pregnancies under specified conditions, a move hailed by activists in a country where clandestine abortions account for a large number of maternal deaths.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.