The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

5161.0: Wednesday, November 19, 2003 - 2:45 PM

Abstract #71982

Effective linkage of jail inmates to community health care: Results from an evaluation of the public health model of correctional health care

Sofia Kennedy, MPH1, Thomas Lincoln, MD, CCHP2, Theodore Hammett, PhD3, Cheryl A Roberts, MPA4, Thomas Conklin, MD, CCHP-A5, Robert Tuthill, PhD5, and Lisa Becchetti1. (1) Abt Associates Inc, 55 Wheeler Street, Cambridge, MA 02138, 617-349-2797,, (2) Brightwood Health Center, Baystate Medical Center & Hampden County Correctional Center, 380 Plainfield St., Springfield, MA 01107, (3) Abt Associates, Inc, 55 Wheeler Street, Cambridge, MA 02138, (4) Abt Associates Inc., 55 Wheeler Street, Cambridge, MA 02138, (5) Health Services, Hampden County Correctional Center, 627 Randall Road, Ludlow, MA 01056

The public health model of correctional health care is a collaboration between a county jail in western Massachusetts, four community health centers and a state public health department. The model uses dually-based physicians and case managers to care for patients in jail and the community after release.

A recent evaluation was undertaken to estimate the effects of the model on healthcare utilization post-release. Patients were interviewed at baseline (n=200) and six months after release (n=131) to assess the rate at which they used community primary care, emergency rooms and hospitals for medical and mental health conditions in the six-month periods prior to and following incarceration. Data were collected from jail medical records to determine the amount of services (physician visits, mental health provider visits, case management, discharge planning, and post-release appointments for care) that participants received at the jail. Eligible inmates were admitted to and released from the jail between April 5, 2000 and September 16, 2001 and had a qualifying chronic medical (n=162) or mental health (n=93) condition including HIV/AIDS (53 were dually-diagnosed).

Using multivariate modeling we found a statistically significant association between a composite jail intervention variable and the hypothesized increase in post-release physician visits for medical care (even more likely if an appointment was made) and mental health care (even more likely if a discharge plan was developed). Importantly, the most cost-effective and replicable component of the model—scheduling a post-release medical appointment—is a statistically significant predictor of increased participation in primary care post-release.

Learning Objectives:

Keywords: Correctional Health Care, Service Delivery

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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.

Research and Evaluation

The 131st Annual Meeting (November 15-19, 2003) of APHA