Supporting continuity of care between prison and the community for women in prison: a medical record reviewPenelope Abbott A D , Parker Magin B , Sanja Lujic C and Wendy Hu A
A School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia. Email: email@example.com
B School of Medicine and Public Health, University of Newcastle, Newbolds Building, University Drive, Newcastle, NSW 2308, Australia. Email: firstname.lastname@example.org
C Centre for Big Data Research in Health, UNSW Australia, Sydney, NSW 2052, Australia. Email: email@example.com
D Corresponding author. Email: firstname.lastname@example.org
Australian Health Review - https://doi.org/10.1071/AH16007
Submitted: 6 January 2016 Accepted: 24 May 2016 Published online: 29 July 2016
Objectives The aim of the present study was to examine health information transfer and continuity of care arrangements between prison and community health care providers (HCPs) for women in prison.
Methods Medical records of women released from New South Wales prisons in 2013–14 were reviewed. Variables included health status, health care in prison and documented continuity of care arrangements, including information transfer between prison and community. Associations were measured by adjusted odds ratios (AORs) using a logistic regression model. Text from the records was collected as qualitative data and analysed to provide explanatory detail.
Results In all, 212 medical records were systematically sampled and reviewed. On prison entry, information was requested from community HCPs in 53% of cases, mainly from general practitioners (GPs, 39%), and was more likely to have occurred for those on medication (AOR 7.08; 95% confidence interval (CI) 3.71, 13.50) or with schizophrenia or other psychotic disorders (AOR 4.20; 95% CI 1.46, 12.11). At release, continuity of care arrangements and health information transfer to GPs were usually linked to formal pre-release healthcare linkage programs. Outside these programs, only 20% of records had evidence of such continuity of care at release, with the odds higher for those on medication (AOR 8.28; 95% CI 1.85, 37.04) and lower for women with problematic substance misuse (AOR 0.32; 95% CI 0.14, 0.72). Few requests for information were received after individuals had been released from custody (5/212; two from GPs).
Conclusion Increased health information transfer to community HCPs is needed to improve continuity of care between prison and community.
What is known about the topic? Many women in prison have high health needs. Health and well being are at further risk at the time of transition between prison and community.
What does this paper add? This study provides evidence that outside formal programs, which are currently available only for a minority of women, continuity of care arrangements and transfer of health information do not usually occur when women leave prison. Pragmatic choices about continuity of care at the interface between prison and community may have been made, particularly focusing on medication continuity. Barriers to continuity of care and ways forward are suggested.
What are the implications for practitioners? Siloing of health care delivered within prison health services through lack of continuity of care at release is wasteful, both in terms of healthcare costs and lost opportunities to achieve health outcomes in a vulnerable population with high health needs. There is need for an increased focus on continuity of care between prison and community health services, HCP support and training and expansion of pre-release planning and healthcare linkage programs to assist larger numbers of women in prison.
Additional keywords: delivery of health care, general practitioners, patient discharge, primary care, prisoners.
References Hockings BA, Young M, Falconer A, O’Rourke PK. Queensland women prisoners’ health survey. Brisbane: Queensland Department of Corrective Services; 2002.
 Indig D, Topp L, Ross B, Mamoon H, Border B, Kumar S, McNamara M. 2009 NSW inmate health survey: key findings report. Sydney: Justice Health; 2010.
 Australian Institute of Health and Welfare (AIHW). The health of Australia’s prisoners 2012. Catalogue no. PHE 170. Canberra: AIHW; 2013.
 Kinner SA, Preen DB, Kariminia A, Butler T, Andrews JY, Stoove M, Law M. Counting the cost: estimating the number of deaths among recently released prisoners in Australia. Med J Aust 2011; 195 64–8.
| 21770872PubMed |
 Pratt D, Piper M, Appleby L, Webb R, Shaw J. Suicide in recently released prisoners: a population-based cohort study. Lancet 2006; 368 119–23.
| Suicide in recently released prisoners: a population-based cohort study.CrossRef | 16829295PubMed |
 Mallik-Kane K, Visher CA. Health and prisoner reentry: how physical, mental, and substance abuse conditions shape the process of reintegration. Washington: The Urban Institute; 2008.
 Feron JM, Paulus D, Tonglet R, Lorant V, Pestiaux D. Substantial use of primary health care by prisoners: epidemiological description and possible explanations. J Epidemiol Community Health 2005; 59 651–5.
| Substantial use of primary health care by prisoners: epidemiological description and possible explanations.CrossRef | 1:STN:280:DC%2BD2MzmtlKjtQ%3D%3D&md5=607d218caa57ca2e9a1f483014bdd505CAS | 16020641PubMed |
 Abbott P, Magin P, Hu W. Health care delivery for women in prison: a medical record review. Aust J Primary Health 2016;
| Health care delivery for women in prison: a medical record review.CrossRef |
 Plugge E, Douglas N, Fitzpatrick R. Patients, prisoners, or people? Women prisoners’ experiences of primary care in prison: a qualitative study. Br J Gen Pract 2008; 58 e1–8.
| Patients, prisoners, or people? Women prisoners’ experiences of primary care in prison: a qualitative study.CrossRef |
 Feron JM, Tan LH, Pestiaux D, Lorant V. High and variable use of primary care in prison. A qualitative study to understand help-seeking behaviour. Int J Prison Health 2008; 4 146–55.
| High and variable use of primary care in prison. A qualitative study to understand help-seeking behaviour.CrossRef | 18698529PubMed |
 Condon L, Hek G, Harris F, Powell J, Kemple T, Price S. Users’ views of prison health services: a qualitative study. J Adv Nurs 2007; 58 216–26.
| Users’ views of prison health services: a qualitative study.CrossRef | 17474910PubMed |
 Baldry E, McDonnell D, Maplestone P, Peeters M. Ex-prisoners, homelessness and the state in Australia. Aust N Z J Criminol 2006; 39 20–33.
| Ex-prisoners, homelessness and the state in Australia.CrossRef |
 National Indigenous Drug and Alcohol Committee. Bridges and barriers: addressing Indigenous incarceration and health. Canberra: Australian National Council on Drugs; 2009.
 Martire K, Sunjic S, Topp L, Indig D. Financial sanctions and the justice system: fine debts among New South Wales prisoners with a history of problematic substance use. Aust N Z J Criminol 2011; 44 258–71.
| Financial sanctions and the justice system: fine debts among New South Wales prisoners with a history of problematic substance use.CrossRef |
 Dyer W, Biddle P. Prison health discharge planning: evidence of an integrated care pathway or the end of the road? Soc Policy Soc 2013; 12 521–32.
| Prison health discharge planning: evidence of an integrated care pathway or the end of the road?CrossRef |
 Lloyd JE, Delaney-Thiele D, Abbott P, Baldry E, McEntyre E, Reath J, Indig D, Sherwood J, Harris MF. The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community. BMC Fam Pract 2015; 16 86
| The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community.CrossRef | 26198338PubMed |
 Martire KA, Howard MVA, Sayle MA, Sunjic SS. Connections program patients: a descriptive analysis of the reintegration needs of incarcerated substance users. J Alcoholism Drug Depend 2013; 1 6
 Justice Health & Forensic Mental Health Network. 2014/2015 Year in review. Sydney: NSW Health; 2015.
 Kouyoumadjian FG, Schuler A, Hwang SW, Matheson FI. Research on the health of people who experience detention or incarceration in Canada: a scoping review. BMC Pub Health 2015; 15 419
 Corben S. NSW inmate census 2013. Statistical publication number 41. Sydney: Corrective Services NSW; 2014.
 Alan J, Burmas M, Preen D, Pfaff J. Inpatient hospital use in the first year after release from prison: a Western Australian population-based record linkage study. Aust N Z J Public Health 2011; 35 264–9.
| Inpatient hospital use in the first year after release from prison: a Western Australian population-based record linkage study.CrossRef | 21627727PubMed |
 Young JT, Arnold-Reed D, Preen D, Bulsara M, Lennox N, Kinner SA. Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: prospective cohort study. BMJ Open 2015; 5 e008021
| Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: prospective cohort study.CrossRef | 26068513PubMed |
 Hampton S, Blomgren D, Roberts J, Mackinnen T, Nicholls G. Prescribing for people in custody. Aust Prescr 2015; 38 160–3.
| Prescribing for people in custody.CrossRef | 26648653PubMed |
 Abbott P, Davison J, Magin P, Hu W. ‘If they’re your doctor they should care about you’: women on release from prison and general practitioners. Aust Fam Physician 2016; in press.
| 27052053PubMed |
 Centre for the Human Rights of Imprisoned People. Culturally and linguistically diverse women in Victorian prisons. Melbourne: Springvale Monash Legal Service; 2010.
 Price MI, Lau FY. Provider connectedness and communication patterns: extending continuity of care in the context of the circle of care. BMC Health Serv Res 2013; 13 309
 Reid DB, Parsons SR, Gill SD, Hughes AJ. Discharge communication from inpatient care: an audit of written medical discharge summary procedure against the new National Health Service Standard for clinical handover. Aust Health Rev 2015; 39 197–201.
| Discharge communication from inpatient care: an audit of written medical discharge summary procedure against the new National Health Service Standard for clinical handover.CrossRef | 25494034PubMed |
 Poroch N, Tongs J, Longford E, Keed S. Aboriginal health workers at Winnunga Nimmityjah Aboriginal health service caring for the needs of Aboriginal people in the new ACT prison and the needs of their families. Aborig Isl Health Work J 2012; 36 6–8, 17.
 Bai JR, Mukherjee DV, Befus M, Apa Z, Lowy FD, Larson EL. Concordance between medical records and interview data in correctional facilities. BMC Med Res Methodol 2014; 14 50
| Concordance between medical records and interview data in correctional facilities.CrossRef | 24716525PubMed |
 Australian Institute of Health and Welfare (AIHW) Cultural and linguistic diversity measures in aged care. Catalogue no. AGE 74. Canberra: AIHW; 2014.
 Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002; 32 959–76.
| 1:STN:280:DC%2BD38vls1Wltg%3D%3D&md5=443a98d745772437a4c39f35743d0a6cCAS | 12214795PubMed |