LeMasters Katherine, Levintow Sara N, Berk Justin, Martino Sarah, Paquette Catherine, Vanjani Rahul, Brinkley-Rubinstein Lauren
Division of General Internal Medicine, University of Colorado School of Medicine, 8 Floor, Academic Office 1, Mailstop B180, 12631 E 17 Ave, Aurora, CO, 80045, USA.
Department of Epidemiology, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
BMC Health Serv Res. 2024 Dec 21;24(1):1631. doi: 10.1186/s12913-024-12110-9.
After release from incarceration, individuals are rarely connected to primary care or to social services despite bearing a disproportionate burden of poor health (e.g., chronic illness) and structural determinants of health (e.g., housing instability). The Rhode Island Transitions Clinic (RITC) works to fill this gap, particularly for patients with complex needs, by linking individuals to primary care and social services. However, prior work has not formally assessed how successful the TCN is at connecting patients to social services. Our objective was to assess the relationship between RITC and connections to healthcare use and services addressing structural determinants of health.
This retrospective cohort study utilizes data among those released from the Rhode Island Department of Corrections (RIDOC) from 2018-2020. These data were linked with state agency data (e.g., unemployment, Medicaid medical claims, housing and homelessness services). We estimated 6-month risk differences (RDs) of each outcome, using stabilized inverse probability weights to account for censoring and confounding.
Of 8,694 individuals, the 68 enrolled in RITC are, on average, older, more likely to be Black, and have had more incarcerations. The RITC was associated with higher likelihood of connection to housing and homelessness services (RD: 0.29; 95% CI: 0.17, 0.41), (re)instatement of Supplemental Security Income (RD: 0.17, 95% CI: 0.06, 0.28), Emergency Department (RD: 0.29; 95% CI: 0.17, 0.41), and primary care visits (RD: 0.32; 95% CI: 0.21, 0.43), and lower likelihood of receiving taxable wages (RD: -0.05; 95% CI: -0.14, 0.05) compared to not being in RITC within six-months of release.
RITC patients have complex healthcare and social service needs. The RITC is an innovative approach that is successful at connecting its patients to primary care and social services.
刑满释放人员尽管承担着不成比例的健康问题负担（如慢性病）和健康的结构性决定因素（如住房不稳定），但很少能获得初级医疗保健或社会服务。罗德岛过渡诊所（RITC）致力于填补这一空白，特别是针对有复杂需求的患者，通过将个人与初级医疗保健和社会服务联系起来。然而，先前的研究尚未正式评估过渡诊所（TCN）在将患者与社会服务联系起来方面的成功程度。我们的目标是评估RITC与医疗保健使用以及解决健康结构性决定因素的服务之间的关系。
这项回顾性队列研究利用了2018年至2020年从罗德岛惩教部（RIDOC）释放的人员的数据。这些数据与州机构数据（如失业、医疗补助医疗索赔、住房和无家可归服务）相关联。我们使用稳定的逆概率权重来估计每个结果的6个月风险差异（RDs），以考虑删失和混杂因素。
在8694名个体中，登记参加RITC的68人平均年龄更大，更有可能是黑人，并且有更多次入狱经历。与释放后六个月内未参加RITC相比，RITC与获得住房和无家可归服务的可能性更高（RD：0.29；95%置信区间：0.17，0.41）、恢复补充保障收入（RD：0.17，95%置信区间：0.06，0.28）、急诊就诊（RD：0.29；95%置信区间：0.17，0.41）和初级保健就诊（RD：0.32；95%置信区间：0.21，0.43）相关，而获得应税工资的可能性更低（RD：-0.05；95%置信区间：-0.14，0.05）。
RITC的患者有复杂的医疗保健和社会服务需求。RITC是一种创新方法，成功地将其患者与初级医疗保健和社会服务联系起来。
