Former prisoners, parolees turn to emergency departments for care

Being released from prison or jail is a difficult time for the millions of Americans returning to their communities from correctional facilities. Add to the list of challenges a high risk of winding up in the emergency department or the hospital. That's according to a new study from the University of Colorado School of Medicine.

The study, published in the Journal of General Internal Medicine, provides support for efforts to improve access to insurance and readily available health care for this vulnerable group.

"This study comes at a time when the Affordable Care Act is improving access to health insurance for the large population leaving the nation's prisons and jails," said study author Joseph Frank, MD, MPH, assistant professor at the CU School of Medicine.

Frank and his colleagues from the Yale University School of Medicine and Harvard Medical School found significantly increased use of hospital and emergency department services among adults in this group. Using recent data from the National Survey on Drug Use and the Medical Expenditure Panel Survey, the researchers examined both healthcare utilization and costs by this group.

Their findings show:

• A 21% increase in risk of hospitalization and a 35% increase in risk of ED use among individuals recently on parole or probation compared with the general population.
• A 26% increase in risk of hospitalization and an 81% increase in risk of ED use among individuals who had been arrested without further criminal justice involvement.
• An estimated additional $8.5 billion in hospital costs and $5.2 billion in ED costs attributable to this increased utilization.

"These findings highlight the potential cost savings if hospital and ED use can be prevented through access to timely, preventive care," Frank said. "They also suggest opportunities across the criminal justice system to identify individuals with medical needs who could benefit from health insurance coverage."

The article, Increased Hospital and Emergency Department Utilization by Individuals with Recent Criminal Justice Involvement: Results of a National Survey is published online in the Journal of General Internal Medicine, May 2014.