Lloyd Jane E, McEntyre Elizabeth, Baldry Eileen, Trofimovos Julian, Indig Devon, Abbott Penelope, Reath Jennifer, Malera-Bandjalan Kathy, Harris Mark F
Centre for Primary Health Care and Equity, Faculty of Medicine, University of New South Wales, Sydney, Australia.
School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, Australia.
Int J Equity Health. 2017 Jan 5;16(1):3. doi: 10.1186/s12939-016-0497-3.
People who have been in custody are more likely to experience multiple, long standing health issues. They are at high risk of illness and injury post release and experience poor access to health services both of which contribute to high rates of recidivism. The study was conducted to examine Aboriginal and non-Aboriginal former prisoners' risk of hospitalisation and rehospitalisation in the five years post release from custody and identified the common reasons for hospitalisations.
Common reasons for hospital admission were identified by conducting descriptive analysis of linked data, related to former prisoners, from NSW Ministry of Health and Corrective Services NSW. This relied upon admitted patient data for 1899 patients. Of this cohort, 1075 people had been admitted to hospital at least once and remained out of custody over a five year period. The independent variables we studied included age, sex, and whether or not the person was Aboriginal. We conducted univariate and multivariate analysis on the following dependent variables: number of admissions over five years after release; more than one admission; days between custody and first hospitalisation; and days between first and second hospitalisation.
Mental and behavioural disorders, injuries and poisoning, and infectious or parasitic diseases were the three most common reasons for admission. Aboriginal and non-Aboriginal former prisoners had a broadly similar pattern of reasons for admission. Yet Aboriginal former prisoners were more likely than non-Aboriginal former prisoners to have a shorter mean interval between hospital admission and readmission (187 days compared to 259 days, t = 2.90, p-0.004).
Despite poorer health among Aboriginal people, there were broadly similar patterns of reasons for admission to hospital among Aboriginal and non-Aboriginal former prisoners. There may be a number of explanations for this. The cohort was not a representative sample of the NSW prison population. There was an overrepresentation of individuals with cognitive disability (intellectual disability, acquired brain injury, dementia, fetal alcohol spectrum disorder) in the study population, which may have impacted on this group accessing hospital health care. Alternatively perhaps there were fewer presentations to hospital by Aboriginal former prisoners despite a greater need. The shorter interval between hospital admission and readmission for Aboriginal former prisoners may suggest the need for better follow up care in the community after discharge from hospital. This presents an opportunity for primary health care services to work more closely with hospitals to identify and manage Aboriginal former prisoners discharged from hospital so as to prevent readmission.
被羁押人员更有可能经历多种长期健康问题。他们在获释后患病和受伤的风险很高，且获得医疗服务的机会有限，这两者都导致了高累犯率。本研究旨在调查原住民和非原住民前囚犯在从羁押中获释后的五年内住院和再次住院的风险，并确定住院的常见原因。
通过对新南威尔士州卫生部和新南威尔士州惩教服务部提供的与前囚犯相关的关联数据进行描述性分析，确定住院的常见原因。这依赖于1899名患者的住院患者数据。在这个队列中，1075人在五年内至少住院一次且未被羁押。我们研究的自变量包括年龄、性别以及该人是否为原住民。我们对以下因变量进行了单变量和多变量分析：释放后五年内的住院次数；多次住院；羁押与首次住院之间的天数；以及首次和第二次住院之间的天数。
精神和行为障碍、损伤和中毒以及传染病或寄生虫病是最常见的三种住院原因。原住民和非原住民前囚犯的住院原因模式大致相似。然而，原住民前囚犯比非原住民前囚犯在住院和再次住院之间的平均间隔时间更短（分别为187天和259天，t = 2.90，p = 0.004）。
尽管原住民的健康状况较差，但原住民和非原住民前囚犯的住院原因模式大致相似。对此可能有多种解释。该队列并非新南威尔士州监狱人口的代表性样本。研究人群中认知障碍（智力残疾、后天性脑损伤、痴呆、胎儿酒精谱系障碍）患者的比例过高，这可能影响了该群体获得医院医疗服务的机会。或者，尽管原住民前囚犯的需求更大，但他们去医院就诊的次数可能更少。原住民前囚犯住院和再次住院之间的间隔时间较短，这可能表明在出院后社区需要更好的后续护理。这为初级卫生保健服务机构提供了一个机会，使其能够与医院更紧密合作，识别和管理从医院出院的原住民前囚犯，以防止再次住院。
