爱尔兰监狱中的初级医疗保健。
Primary medical care in Irish prisons.
机构信息
Department of Public Health & Primary Care, Trinity College, Dublin, Ireland.
出版信息
BMC Health Serv Res. 2010 Mar 22;10:74. doi: 10.1186/1472-6963-10-74.
BACKGROUND
An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review.
METHODS
This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT) inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS. Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care. Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available.
RESULTS
There was wide variation in the standard of medical facilities and infrastructure provided across the IPS. The range of medical equipment available was generally below that of the equivalent general practice scheme in the community. There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population. There is limited administrative support, with the majority of prisons not having a medical secretary. There are few psychiatric or counselling sessions available.
CONCLUSIONS
People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons.
背景
2004 年，监狱医生与爱尔兰监狱管理局（IPS）之间发生了一场劳资纠纷。该纠纷的部分解决方案是，由大学初级保健部门对监狱医疗和支持服务进行独立审查。该审查于 2008 年进行，我们在此报告该审查的主要结果。
方法
本研究采用混合方法。一名独立的医学专家评估员（作者之一，DT）检查了 IPS 内 14 所监狱中的 11 所的医疗设施、设备和相关拘留区。对负责提供监狱医疗服务的人员进行了半结构化访谈。监狱医生填写了一份问卷，以了解医生时间分配、护士和行政支持以及可用资源等问题。
结果
IPS 提供的医疗设施和基础设施标准存在很大差异。可用医疗设备的范围通常低于社区内同等的一般实践计划。该系统内部存在不平等现象，医生签约时间与监狱人口规模的比例存在差异。行政支持有限，大多数监狱没有医疗秘书。可提供的精神科或咨询课程很少。
结论
监狱中的人有广泛的医疗需求，有证据表明，这些需求在爱尔兰监狱中得到的满足不一致。
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