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城市监禁后过渡诊所患者出狱后的健康状况及护理持续情况。

Health outcomes and retention in care following release from prison for patients of an urban post-incarceration transitions clinic.

作者信息

Fox Aaron D, Anderson Matthew R, Bartlett Gary, Valverde John, Starrels Joanna L, Cunningham Chinazo O

出版信息

J Health Care Poor Underserved. 2014 Aug;25(3):1139-52. doi: 10.1353/hpu.2014.0139.

Abstract

Chronic health conditions are overrepresented among prisoners who often face barriers to medical care following release. Transitions clinics seek to provide timely access to medical care following release. This retrospective cohort study investigated care delivery and health outcomes for recently released prisoners receiving care at the Bronx Transitions Clinic. Among 135 recently released prisoners, median time from release to initial medical visit was 10 days (IQ Range: 5-31). Six-month retention in care was high for HIV-infection (86%), but lower for opioid dependence (33%), hypertension (45%) and diabetes (43%). At six months, 54% of HIV-patients had a suppressed viral load, but fewer buprenorphine-treated patients reduced opioid use (19%), and fewer hypertensive and diabetic patients reached respective blood pressure (35%) and hemoglobin A1c (14%) goals. Access to medical care is necessary but not sufficient to control chronic health conditions. Additional interventions are necessary for formerly incarcerated people to achieve optimal health outcomes.

摘要

慢性健康状况在囚犯中占比过高,这些囚犯获释后面临医疗保健方面的诸多障碍。过渡诊所致力于在囚犯获释后及时提供医疗服务。这项回顾性队列研究调查了在布朗克斯过渡诊所接受治疗的近期获释囚犯的医疗服务提供情况和健康结果。在135名近期获释的囚犯中,从获释到首次就诊的中位时间为10天(四分位距:5 - 31天)。感染艾滋病毒者的六个月护理留存率较高(86%),但阿片类药物依赖者(33%)、高血压患者(45%)和糖尿病患者(43%)的留存率较低。六个月时,54%的艾滋病毒患者病毒载量得到抑制,但接受丁丙诺啡治疗的患者中减少阿片类药物使用的人数较少(19%),达到各自血压目标(35%)和糖化血红蛋白目标(14%)的高血压和糖尿病患者也较少。获得医疗服务是控制慢性健康状况的必要条件,但并不充分。对于曾经入狱的人来说,还需要其他干预措施才能实现最佳健康结果。

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