The pivotal role of primary care in meeting the health needs of people recently released from prison
The pivotal role of primary care in meeting the health needs of people recently released from prison
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DOI：
10.1177/1039856215613008
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发表时间：
2015-12-01
影响因子：
1.8
通讯作者：
Carroll, Megan
中科院分区：
文献类型：
--
作者：
Kinner, Stuart A.;Young, Jesse T.;Carroll, Megan
目标：澳大利亚监狱人口的增长速度远远超过人口增长速度。澳大利亚土著人的比例高出 13 倍。囚犯是一个被严重边缘化的群体，其健康和社会需求复杂。尽管监禁期间健康状况有所改善，但释放后健康状况不佳的情况很常见，而且监禁的净效应通常是健康耗竭。鉴于需要有效的护理协调，初级保健在满足该人群的健康需求方面发挥着关键作用。在本文中，我们回顾了刑满释放人员初级保健利用模式的已知情况，确定了增加刑满释放人员获得初级保健机会的循证策略，并考虑了这种接触如何影响随后的卫生服务结果。结论：初级保健是有效的释放后支持的必要条件，但不是充分条件。积极的结果可能更多地取决于所接受护理的质量而不是数量。鉴于澳大利亚监狱中原住民人数过多，并且有令人信服的证据表明出狱后的发病率和死亡率是可以预防的，针对该人群的有效护理模式是缩小原住民预期寿命差距的重要组成部分。
Objective: Australia's prison population is growing at a rate well in excess of population growth. Indigenous Australians are over-represented by a factor of 13. Prisoners are a profoundly marginalised group characterised by complex health and social needs. Despite improvements in health during incarceration, poor health outcomes after release are common, and the net effect of incarceration is usually health depleting. Given the need for effective care coordination, primary care plays a pivotal role in meeting the health needs of this population. In this paper we review what is known about patterns of primary care utilisation in ex-prisoners, identify evidence-based strategies for increasing access to primary care in ex-prisoners, and consider how such contact may shape subsequent health service outcomes.Conclusions: Primary care is a necessary but not sufficient condition for effective post-release support. Positive outcomes may depend more on the quality than the quantity of care received. Given massive over-representation of Indigenous people in Australia's prisons, and compelling evidence of preventable morbidity and mortality after release from prison, effective models of care for this population are an important component of closing the gap in Indigenous life expectancy.