Use of Health Care Services in a Sample of Drug-Involved Offenders

Abstract

There is evidence to suggest that drug-involved offenders are more likely to have chronic health problems, which would lead to the expectation that this group would be consumers of a disproportionate amount of health care services. However, other characteristics of the group, including higher rates of unemployment and less likelihood of health insurance, suggest that they may consume relatively low amounts of health services. This study reports on a cohort of drug-involved offenders in Delaware who were interviewed just before release from prison and again at several points following release. When compared to age- and gender-corrected norms from the National Health Interview Survey, the use of health services for drug- and alcohol-related conditions as well as for other physical conditions were all substantially higher for this group of offenders. Discussion centers on the role of drug treatment programs in reducing the need for health care services.

A Prospective Examination of High-cost Health Services Utilization among Drug using Prisoners Reentering the Community

“…As expected, health status was the most robust predictor of health services utilization for these drug using male offenders after their release from prison, even after statistically controlling for the length of time at risk in the community. This finding is consistent with findings reported by McCorkel et al 21 The majority (59%) of these males do not have health insurance. This suggests that public health and public hospital medical care can be expected to continue to be used to treat the health problems of male drug-abusing offenders who reenter the community.…”

“…The few prospective studies indicate that prisoners use a number of health services while incarcerated, [18][19][20] and use high-cost health care services such as emergency rooms when they return to the community, particularly when access to preventative and continuing care is not available. 21 Clearly, there is a need to better understand health services utilization among drug-abusing prisoners after community reentry.…”

Increased Hospital and Emergency Department Utilization by Individuals with Recent Criminal Justice Involvement: Results of a National Survey

“…In a cohort of 820 drug-involved ex-prisoners in Delaware, rates of hospitalization were increased more than threefold compared with a national sample. 10 In a separate study of 476 adult women recently released from New York City jails, half reported ED use and 24 % reported a hospitalization over an average of 15 months. 11 In a cohort of 151 ex-prisoners with HIV infection in Connecticut, 56 % had at least one ED visit in the 12 months following release.…”

“…5 Previous studies have documented increased healthcare utilization by this population, but have been geographically limited or focused on specific subgroups. [10][11][12][13][14] This healthcare utilization will become increasingly relevant to state and federal policymakers with implementation of the Patient Protection and Affordable Care Act, as an estimated 53-57 % of individuals leaving prison will be eligible for Medicaid or subsidized private insurance. 15 Early evidence suggests that programs to improve access to care on release from prison may prevent high-cost utilization in the community.…”

Health Care Utilization Among Drug-Using and Non-Drug-Using Women

“…[18][19][20][21][22][23][24][25][26][27][28] In this article, we address those factors that have traditionally been associated with health care utilization in previous studies, but also examine the independent and interrelated contribution of age and drug use to utilization of services among a group of potentially underserved women. Given the high and possibly increasing mortality rate among many drug users, 29 often coupled with a high prevalence of unemployment, poor education, AIDS, criminal behavior, mental illness, and inadequate social support, 13,21,22 one would assume that many chronic drug users may be in the greatest need of care due to direct and indirect consequences of drug use. 13 Drug abuse has been associated with increased health care costs, increased health problems, and excessive use of emergency department care.…”