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Comparative Study
. 2013 Sep 23;173(17):1621-8.
doi: 10.1001/jamainternmed.2013.9008.

A high risk of hospitalization following release from correctional facilities in Medicare beneficiaries: a retrospective matched cohort study, 2002 to 2010

Emily A Wang  1 , Yongfei Wang, Harlan M Krumholz
Affiliations
Comparative Study

A high risk of hospitalization following release from correctional facilities in Medicare beneficiaries: a retrospective matched cohort study, 2002 to 2010

Emily A Wang et al. JAMA Intern Med. .

Abstract

Importance: Little is known about the risk of individuals who are released from correctional facilities, a time when there may be discontinuity in care.

Objective: To study the risk for hospitalizations among former inmates soon after their release from correctional facilities.

Design: Retrospective cohort study.

Participants: Data from Medicare administrative claims for 110,419 fee-for-service beneficiaries who were released from a correctional facility from 2002 through 2010 and controls matched by age, sex, race, Medicare status, and residential zip code.

Main outcomes and measures: Hospitalization rates and specifically those for ambulatory care-sensitive conditions 7, 30, and 90 days after release.

Results: Of 110,419 released inmates, 1559 individuals (1.4%) were hospitalized within 7 days after release; 4285 individuals (3.9%) within 30 days; and 9196 (8.3%) within 90 days. The odds of hospitalization was higher for released inmates compared with those of matched controls (within 7 days: odds ratio [OR], 2.5 [95% CI, 2.3-2.8]; within 30 days: OR, 2.1 [95% CI, 2.0-2.2]; and within 90 days: OR, 1.8 [95% CI, 1.7-1.9]). Compared with matched controls, former inmates were more likely to be hospitalized for ambulatory care-sensitive conditions (within 7 days: OR, 1.7 [95% CI, 1.4-2.1]; within 30 days: OR, 1.6 [95% CI, 1.5-1.8]; and within 90 days: OR, 1.6 [95% CI, 1.5-1.7]).

Conclusions and relevance: About 1 in 70 former inmates are hospitalized for an acute condition within 7 days of release, and 1 in 12 by 90 days, a rate much higher than in the general population.

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Figures

Figure
Figure. Time to First Hospitalization and Death
Time to first hospitalization (A) and death (B) stratified by incarceration status in the matched cohort of Medicare beneficiaries.
See this image and copyright information in PMC

References

    1. Estelle v Gamble. 1976 429 US 97.
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    1. Binswanger IA, Stern MF, Deyo RA, et al. Release from prison: a high risk of death for former inmates. N Engl J Med. 2007;356(2):157–165. - PMC - PubMed
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