Fadgyas-Freyler P, Münnich Á, Molnár J, Kósa K
Department of Health Policy, Institute of Social and Political Sciences, Corvinus University, Budapest, Hungary.
Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Public Health Pract (Oxf). 2025 Jul 2;10:100639. doi: 10.1016/j.puhip.2025.100639. eCollection 2025 Dec.
Prison population around the globe tends be among the most marginalized population groups. Many of these persons struggle with numerous health problems, primarily with infectious diseases and mental disorders. Our goal was to analyse morbidity of prisoners compared to age- and gender-matched controls.
Case-control study based on administrative data of healthcare utilisation in Hungary between 2017 and 2019.
Patient numbers by ICD-10 chapters and tabulation lists of diagnosis (morbidity groups) were obtained from the government-funded single payer health insurance institute. Convicts were compared to controls matched by age and gender in a 5:1 ratio.
The leading causes of healthcare utilisation of prisoners compared to controls by ICD-10 chapters were mental and behavioural disorders and external causes of morbidity, but the relative risk of healthcare use due to infectious diseases was not elevated. When investigating data at a more detailed level, that is, by morbidity groups, the relative risk of healthcare utilisation due to 19 out of a total of 299 morbidity groups was significantly, more than 3 times higher among prisoners compared to controls, and the first five highest relative risks were all due to external causes of injury.
The leading causes of morbidity among persons in prisons based on health care utilisation seems to be somewhat different from morbidity patterns identified by other methods such as clinical interviews, screening or estimations. Causes of health care utilisation both at ICD chapter and morbidity group-level is one of several relevant indicators of the health care needs of prison populations that uncovers the groups of most severe maladies among them. However, other sources of data should also be taken into account for the development of effective preventive and rehabilitative interventions. Follow-up of prisoner patients treated in health care would also be recommended to aid rehabilitation.
全球监狱人口往往是最边缘化的人群之一。这些人中许多人都面临着众多健康问题，主要是传染病和精神障碍。我们的目标是分析与年龄和性别匹配的对照组相比，囚犯的发病率。
基于2017年至2019年匈牙利医疗保健利用行政数据的病例对照研究。
从政府资助的单一支付者健康保险机构获取按国际疾病分类第十版（ICD - 10）章节和诊断列表（发病组）划分的患者数量。将罪犯与按年龄和性别以5:1比例匹配的对照组进行比较。
按ICD - 10章节划分，与对照组相比，囚犯医疗保健利用的主要原因是精神和行为障碍以及发病的外部原因，但传染病导致的医疗保健使用相对风险并未升高。在更详细的层面，即按发病组调查数据时，在总共299个发病组中，有19个发病组导致的医疗保健利用相对风险在囚犯中显著高于对照组，是对照组的3倍多，且前五个最高相对风险均由外部伤害原因导致。
基于医疗保健利用情况，监狱中人群发病的主要原因似乎与通过临床访谈、筛查或估计等其他方法确定的发病模式有所不同。ICD章节和发病组层面的医疗保健利用原因是揭示监狱人群中最严重疾病群体的监狱人群医疗保健需求的若干相关指标之一。然而，在制定有效的预防和康复干预措施时，还应考虑其他数据来源。建议对接受医疗保健治疗的囚犯患者进行随访，以帮助康复。
