Simpler Amber, Natoli Adam, Patade Yash, Jett William
NaphCare Charitable Foundation, Inc., Birmingham, AL, United States.
Natoli Services LLC, Huntsville, TX, United States.
Health Justice. 2025 Jun 16;13(1):39. doi: 10.1186/s40352-025-00345-5.
Recognizing the disparate health status of correctional populations compared to the general population, national agencies have called for research to better understand disease epidemiology and healthcare needs of individuals in jails. This paper introduces the Registry of Electronic Archives in Correctional Healthcare (REACH) database - a largescale, multivariable living database derived from electronic healthcare records (EHR) of individuals discharged from jails across the nation beginning in 2013. We describe methods used to secure data, detail current database contents, and offer an initial presentation of sample demography. To demonstrate REACH's utility, an investigation of factors contributing to length of stay (LOS), including demography, health status, and jail characteristics, was conducted.
The current REACH sample (N = 1,251,837) is primarily comprised of males (72.0%) identified racially as White (55.3%) in their mid-30's. While detained, approximately 20% and 17% of individuals were prescribed treatment for chronic medical and/or mental health conditions, respectively. Multilevel modeling was used to examine if sex, race, health condition, and/or jail location or size predicted LOS.
By accessing EHR data, we can expand our understanding of assessment and treatment of specific healthcare conditions in jail populations and address complicated questions about health status of detainees. Data analysis using the REACH database suggests LOS is influenced slightly by jail characteristics and more substantively by detainee demography and medical/mental health conditions. We propose the REACH database's potential for answering important questions about health status and healthcare services for jail populations, including questions about epidemiology and correctional healthcare.
鉴于惩教机构中的人群与普通人群的健康状况存在差异，国家机构呼吁开展研究，以更好地了解监狱中个体的疾病流行病学和医疗保健需求。本文介绍了惩教医疗电子档案注册库（REACH）数据库——一个大规模的多变量动态数据库，它源自2013年起从全国各地监狱释放的个体的电子医疗记录（EHR）。我们描述了用于保护数据的方法，详细说明了当前数据库的内容，并初步展示了样本人口统计学信息。为了证明REACH的实用性，我们对影响住院时间（LOS）的因素进行了调查，包括人口统计学、健康状况和监狱特征。
目前的REACH样本（N = 1,251,837）主要由35岁左右的男性（72.0%）组成，种族上被认定为白人（55.3%）。在被拘留期间，分别约有20%和17%的个体接受了慢性医疗和/或心理健康状况的治疗。使用多层次模型来检验性别、种族、健康状况和/或监狱位置或规模是否能预测住院时间。
通过获取电子病历数据，我们可以扩大对监狱人群特定医疗状况评估和治疗的理解，并解决有关被拘留者健康状况的复杂问题。使用REACH数据库进行的数据分析表明，住院时间受监狱特征的影响较小，而受被拘留者人口统计学和医疗/心理健康状况的影响更大。我们提出REACH数据库在回答有关监狱人群健康状况和医疗服务的重要问题方面具有潜力，包括有关流行病学和惩教医疗的问题。
