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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Thomas Lincoln, MD, CCHP1, Thomas Conklin, MD, CCHP-A2, Robert Tuthill, PhD2, Sofia Kennedy, MPH3, Cheryl Ann Roberts, MPA4, James Vivian, PhD2, and Theodore Hammett, PhD3. (1) Brightwood Health Center, Baystate Medical Center & Hampden County Correctional Center, 380 Plainfield St., Springfield, MA 01107, (413)794-8375, silklinc@massmed.org, (2) Health Services, Hampden County Correctional Center, 627 Randall Road, Ludlow, MA 01056, (3) Abt Associates, Inc, 55 Wheeler Street, Cambridge, MA 02138, (4) Abt Associates, Inc., 55 Wheeler Street, Cambridge, MA 02138
Medical and correctional professionals are increasingly realizing the extent to which chronic and infectious disease, mental illness, and substance abuse are concentrated in the correctional system. A cooperative program between a county jail, four community health centers, and other agencies in Hampden County, Massachusetts was developed nearly a decade ago which allows the same health providers to care for patients in jail and subsequently in the community. This public health model of correctional health care emphasizes five essential elements: thorough disease screening and detection, early and effective treatment, patient education, prevention, and continuity of care after release. To study this model, the Hampden County Correctional Center (HCCC), with Abt Associates Inc., has undertaken a three-year evaluation sponsored by the Centers for Disease Control and Prevention, the National Institute of Justice, and the Soros Foundation. The main goal of the research is to assess whether the model creates any significant changes in health risk behavior and health care utilization, as well as clinical status and criminal activity, among individuals after release from HCCC. The economic impact of the program is also being studied. Baseline health and behavioral data are collected from inmates with chronic medical or serious psychiatric conditions at the jail. Follow-up interviews are being conducted at one month and six months after release. Preliminary analysis of study participants at intake (n=184), one month post-release (n=89), and six months post-release (n=61) shows significant improvement in self-reported health status (general, emotional, pain), emergency room use, and substance use, but not in sexual risk behavior. The data show some continued risk behavior in jail (e.g., sex, drug use), and the evaluation identifies barriers and facilitators to continuity of health care and social services. Preliminary analysis to determine whether these improvements in the community correlate with the intensity of medical services in jail suggests a greater proportion of individuals in the higher intensity service group have more primary care visits (p=0.12) and fewer emergency room visits (p=0.06) in the six months after release than individuals in the lower service intensity group. By the summer of 2002, data collection will be complete and we expect to present final data and analysis on 198 baseline interviews, 113 1-month interviews, and about 130 six-month interviews.
Learning Objectives: From this session the participant should be able to
Keywords: Jails and Prisons, Community-Based Partnership
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Handout (.ppt format, 329.0 kb)