A High Risk of Hospitalization Following Release From Correctional Facilities in Medicare Beneficiaries A Retrospective Matched Cohort Study, 2002 to 2010
A High Risk of Hospitalization Following Release From Correctional Facilities in Medicare Beneficiaries A Retrospective Matched Cohort Study, 2002 to 2010
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DOI：
10.1001/jamainternmed.2013.9008
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发表时间：
2013-09-23
影响因子：
39
通讯作者：
Krumholz, Harlan M.
中科院分区：
文献类型：
--
作者：
Wang, Emily A.;Wang, Yongfei;Krumholz, Harlan M.
重要性人们对从教养所释放的个人的风险知之甚少，目的研究从惩教机构释放后不久的前囚犯住院的风险。设计回顾性队列研究。参与者数据来自110419名收费的医疗保险行政索赔。从2002年到2010年从惩教机构释放的服务受益人和年龄，性别，种族，医疗保险状态匹配的对照组，主要结果和测量住院率，特别是对门诊护理敏感的情况7，30，结果110419名刑满释放人员中，1559人（1.4%）在刑满释放7 d内住院，4285人（3.9%）在30 d内住院，9196人（8.3%）在90 d内住院。与匹配的对照组相比，释放囚犯的住院几率更高（7天内：比值比[OR]，2.5 [95%CI，2.3-2.8]; 30天内：OR，2.1 [95%CI，2.0-2.2]; 90天内：OR，1.8 [95%CI，1.7-1.9]）。与匹配的对照组相比，前囚犯更有可能因门诊护理敏感的条件而住院（7天内：OR，1.7 [95% CI，1.4-2.1]; 30天内：OR，1.6 [95% CI，1.5-1.8]; 90天内：OR，1.6 [95%CI，1.5-1.7]）。结论和相关性约有1/70的前囚犯在释放后7天内因急性疾病住院治疗，1/12的90天，这一比率远高于一般人群。
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.