Key Points Question What are the current trends in frequency and costs of amphetamine-related hospitalizations in the United States? Findings In this cross-sectional study of approximately 1.3 million amphetamine-related US hospitalizations between 2003 and 2015, hospitalizations increased substantially by 2015, with the highest frequency being in the western United States and the predominant payer being Medicaid. Meaning Amphetamine use may be an emerging public health issue; pharmacologic and nonpharmacologic therapies that effectively treat amphetamine use disorder are needed.

Estimates of chronic conditions and disability among individuals on community supervision in the United States are lacking. We used 2015–2016 data from the National Survey on Drug Use and Health ( N = 78,761) to examine the prevalence of chronic conditions and disability among nonelderly adults who had been on probation or parole in the past year, compared to adults without community supervision in the past year. The weighted sample was representative of 4,594,412 adults on community supervision and 191,156,710 adults without community supervision in the past year. Compared to the general population, adults recently on community supervision were significantly more likely to report fair or poor health, chronic obstructive pulmonary disease, hepatitis B or C, one or more chronic conditions, and any disability. Collaboration between health and criminal justice systems is needed to accommodate the health needs and supervision requirements for individuals with community supervision.

Background-The expansion of Medicaid as part of the Affordable Care Act opened new opportunities to provide health coverage to low-income adults who may be involved in other public sectors. Objective-The main objective of this study was to describe cross-sector utilization patterns among urban Medicaid expansion enrollees. Research Design-We merged data from 4 public sectors (health care, human services, housing, and criminal justice) for 98,282 Medicaid expansion enrollees in Hennepin County, MN. We fit a latent class model to indicators of cross-sector involvement. Measures-Indicator variables described involvement levels within each sector from March 2011 through December 2014. Demographic and chronic condition indicators were included post hoc to characterize classes. Results-We found 6 archetypes of cross-sector involvement: The "Low Contact" class (33.9%) had little involvement in any public sector; "Primary Care" (26.3%) had moderate, stable health care utilization; "Health and Human Services" (15.3%) had high rates of health care and cash assistance utilization; "Minimal Criminal History" (11.0%) had less serious criminal justice involvement; "Cross-sector" (7.8%) had elevated emergency department use, involvement in all 4 sectors, and the highest prevalence of behavioral health conditions; "Extensive Criminal History" (5.7%) had serious criminal justice involvement. The 3 most expensive classes (Health and Human Services, Cross-sector, and Extensive Criminal History) had the highest rates of behavioral health conditions. Together, they comprised 29% of enrollees and 70% of total public costs.

Background In 2016, over 11 million individuals were admitted to prisons and jails in the United States. Because the majority of these individuals will return to the community, addressing their health needs requires coordination between community and correctional health care providers. However, few systems exist to facilitate this process and little is known about how physicians perceive and manage these transitions. Objective The goal of this study was to characterize physicians’ views on transitions both into and out of incarceration and describe how knowledge of a patient’s criminal justice involvement impacts patient care plans. Methods Semi-structured interviews were conducted between October 2018 and May 2019 with physicians from three community clinics in Hennepin County, Minnesota. Team members used a hybrid approach of deductive and inductive coding, in which a priori codes were defined based on the interview guide while also allowing for data-driven codes to emerge. Results Four themes emerged related to physicians’ perceptions on continuity of care for patients with criminal justice involvement. Physicians identified disruptions in patient-physician relationships, barriers to accessing prescription medications, disruptions in insurance coverage, and problems with sharing medical records, as factors contributing to discontinuity of care for patients entering and exiting incarceration. These factors impacted patients differently depending on the direction of the transition. Conclusions Our findings identified four disruptions to continuity of care that physicians viewed as key barriers to successful transitions into and out of incarceration. These disruptions are unlikely to be effectively addressed at the provider level and will require system-level changes, which Medicaid and managed care organizations could play a leading role in developing.