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Open Access Transitional Health Care for Offenders Being Released from United States Prisons Les soins de santé de transition offerts aux ex-détenus après leur mise en liberté aux États-Unis

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Abstract:

Ex-offender managed health care can enhance post-release continuity of care by increasing access, decreasing acute-care episodes, controlling the spread of communicable diseases, and reducing the financial impact on public health-care systems. This study describes transitional health care for inmates with AIDS, tuberculosis (TB), hepatitis, mental illness, and substance abuse. The relationship between size of prison system and coordination of care was also investigated. A mail survey was completed by 33 chief medical officers of prison systems in the United States. Transitional health-care programs for ex-offenders vary widely and no significant relationship was found between number of inmates released per state annually and state coordination of transitional health care for supervised ex-offenders. All respondents reported some type of transitional health-care planning, usually either 1 month or 6 months prior to release. This included provision of post-release medication, referral to community health agencies, scheduling of appointments, and instruction in prevention of transmission. The majority of respondents reported that transitional health-care planning was coordinated by registered nurses. Specific measures for inmates with HIV/AIDS, TB, mental illness, and substance abuse were reported. Information about existing transitional health-care programs can help nurses and other health-care providers identify trends in transitional health-care planning and ensure continuity of care for released offenders.

French
La planification des soins destinés aux détenus après leur mise en liberté peut favoriser la continuité des soins, car elle permet d'améliorer l'accès au système de santé, de réduire les épisodes de soins actifs, de contenir la propagation de maladies transmissibles et de limiter les répercussions financières sur les systèmes publics de santé. Ce projet visait à décrire les soins de santé de transition destinés aux détenus souffrant du sida, de tuberculose, d'hépatite, de maladie mentale ou de toxicomanie. Également, on a étudié le lien entre la taille de la prison et la coordination des soins. Les programmes de soins de transition varient considérablement; on n'a trouvé aucun lien significatif entre le nombre de détenus mis en liberté annuellement dans chaque État et la coordination des soins de santé qui leur sont destinés. Tous les répondants ont rapporté l'existence d'une forme ou autre de planification des soins de transition, habituellement pendant la période précédant de un à six mois la mise en liberté. Les plans tiennent tous compte de la prestation des médicaments, de l'aiguillage vers des organismes de santé communautaire, de l'établissement de rendez-vous et de la recommandation de mesures visant à prévenir la transmission. La majorité des répondants ont indiqué que la planification des soins de transition était coordonnée par des infirmières autorisées. Ils ont aussi fait état de l'établissement de mesures spécifiques à l'intention des détenus souffrant du VIH/sida, de tuberculose, de maladie mentale ou de toxicomanie. Ces données permettront aux infirmières et aux autres prestataires de soins de cerner les tendances en matière de planification des soins de transition et d'assurer la continuité des soins offerts aux ex-détenus.

Keywords: CORRECTIONAL HEALTH CARE; PRISON DISCHARGE PLANNING; TRANSITIONAL HEALTH CARE; VULNERABLE POPULATIONS MODEL

Document Type: Research Article

Publication date: 2004-06-01

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