Centre for International Child Health, Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.
Centre for Health Economics, Monash Business School, Monash University, Melbourne, Vic., Australia.
Aust J Prim Health. 2022 Jun;28(3):264-270. doi: 10.1071/PY21142.
People released from prison have poorer health than the general public, with a particularly high prevalence of mental illness and harmful substance use. High-frequency use of hospital-based services is costly, and greater investment in transitional support and primary care services to improve the health of people leaving prison may therefore be cost-effective.
A prospective cohort study of 1303 men and women released from prisons in Queensland, Australia, between 2008 and 2010, using linked data was performed. We calculated healthcare costs and the cost of re-incarceration. We compared healthcare costs to the general public, and assessed the impact of past mental illness, substance use disorder, and dual diagnosis on both healthcare and criminal justice costs.
Healthcare costs among the cohort were 2.1-fold higher than expected based on costs among the public. Dual diagnosis was associated with 3.5-fold higher healthcare costs (95% CI 2.6-4.6) and 2.8-fold higher re-incarceration costs (95% CI 1.6-5.0), compared with no past diagnosis of either mental illness or substance use disorder.
People released from prison incur high healthcare costs, primarily due to high rates of engagement with emergency health services and hospital admissions. Comorbid mental illness and substance use disorders are associated with high health and criminal justice costs among people recently released from prison.
与普通公众相比，刚出狱的人健康状况较差，他们尤其容易患有精神疾病和滥用有害物质。高频次使用医院服务的成本较高，因此，为改善刚出狱人群的健康状况，对过渡性支持和初级保健服务进行更多投资可能具有成本效益。
对 2008 年至 2010 年期间在澳大利亚昆士兰州监狱中被释放的 1303 名男性和女性进行了一项前瞻性队列研究，使用了关联数据。我们计算了医疗保健费用和重新监禁的费用。我们将医疗保健费用与普通公众进行了比较，并评估了过去的精神疾病、物质使用障碍和双重诊断对医疗保健和刑事司法成本的影响。
该队列的医疗保健费用比基于公众医疗保健费用的预期高出 2.1 倍。与没有过去的精神疾病或物质使用障碍诊断相比，双重诊断与医疗保健费用高出 3.5 倍（95%CI 2.6-4.6）和重新监禁费用高出 2.8 倍（95%CI 1.6-5.0）相关。
刚出狱的人医疗保健费用较高，主要是由于高频次使用急诊卫生服务和住院治疗。最近刚出狱的人患有合并的精神疾病和物质使用障碍与较高的健康和刑事司法成本相关。
