Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 143 No. 0708 (2013)

Emergency department admissions to a prison hospital: a retrospective cohort study from Switzerland

  • Carmen Andrea Pfortmueller
  • Gregor Aulmann
  • Gregor Lindner
  • Martin Perrig
  • Thomas J. Müller
  • Heinz Zimmermann
  • Aristomenis K. Exadaktylos
DOI
https://doi.org/10.4414/smw.2013.13753
Cite this as:
Swiss Med Wkly. 2013;143:w13753
Published
10.02.2013

Summary

INTRODUCTION: There are more than 10 million prison inmates throughout the world and this number is increasing continuously. Prisoners are a particularly vulnerable minority group that has special healthcare needs and demands on healthcare services and providers. The aim of this study was to give an overview of prisoners’ healthcare problems leading to emergency department admission, in order to make recommendations to help to optimise treatment of this target group.

METHODS: Our retrospective data analysis comprised adult (age ≥16 years) prisoners admitted to our emergency department, in transit to admission to our hospital-associated medical prison ward, between 2nd February 2000 and 30th April 2012.

RESULTS: A total of 1703 patients were analysed. Of these, 78.2% (n = 1333) were male and 21.8% (n = 370) female. The mean age was 36.6 years (standard deviation 14.6, range 16–92 years). The most frequent reasons for presentation were psychiatric problems (43.4%; n = 739), followed by the need for medical treatment (31.6%; n = 539) and for surgical treatment (25.0%; n = 425). Patients with medical problems were significantly older than patients with psychiatric and surgical presentations (for both p <0.001). Patients with psychiatric problems were significantly younger than those with medical or surgical problems (p <0.001). A total of 130 (7.6%) of our patients were rehospitalised within the study period.

CONCLUSION: Prisoners are a vulnerable minority group within our society with limited access to medical care. Transfer of information between the emergency department and prison staff should be promoted. Further research should be carried out on prisoners’ healthcare problems.

References

  1. Fazel S, Baillargeon J. The health of prisoners. Lancet. 2011;377(9769):956–65.
  2. Vetter C, Robert-Tissot L, Cottagnoud P, Stucki A. Working under pressure. Praxis. 2008;97(8):437–42.
  3. Watson R, Stimpson A, Hostick T. Prison health care: a review of the literature. Int J Nurs Stud. 2004;41(2):119–28.
  4. Statistiken zum Strafvollzug [http://www.bfs.admin.ch/bfs/portal/de/index/themen/19/03/05/key/vollzug_von_sanktionen/strafvollzug.html.] 27.09.2012
  5. Plugge E, Douglas N, Fitzpatrick R. Patients, prisoners, or people? Women prisoners’ experiences of primary care in prison: a qualitative study. The British journal of general practice: the journal of the Royal College of General Practitioners 2008;58(554):630–6.
  6. Fraser A, Gatherer A, Hayton P. Mental health in prisons: great difficulties but are there opportunities? Public health. 2009;123(6):410–4.
  7. Ford PM, Wobeser WL. Health care problems in prisons. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne 2000;162(5):664–5.
  8. Harris F, Hek G, Condon L. Health needs of prisoners in England and Wales: the implications for prison healthcare of gender, age and ethnicity. Health & social care in the community. 2007;15(1):56–66.
  9. Plugge EH, Foster CE, Yudkin PL, Douglas N. Cardiovascular disease risk factors and women prisoners in the UK: the impact of imprisonment. Health promotion international. 2009;24(4):334–43.
  10. Butler T, Kariminia A, Levy M, Murphy M. The self-reported health status of prisoners in New South Wales. Aust N Z J Public Health. 2004;28(4):344–50.
  11. Rosen DL, Hammond WP, Wohl DA, Golin CE. Disease prevalence and use of health care among a national sample of black and white male state prisoners. J Health Care Poor Underserved. 2012;23(1):254–72.
  12. Fazel S, Benning R. Natural deaths in male prisoners: a 20-year mortality study. Eur J Public Health. 2006;16(4):441–4.
  13. Fazel S, Hope T, O’Donnell I, Piper M, Jacoby R. Health of elderly male prisoners: worse than the general population, worse than younger prisoners. Age Ageing. 2001;30(5):403–7.
  14. Pfortmueller CA, Graf F, Tabarra M, Lindner G, Zimmermann H, Exadaktylos AK. Acute health problems in African refugees: Ten years’ experience in a Swiss emergency department. Wiener klinische Wochenschrift 2012.
  15. Bewachungsstation Inselspital ['Http://www.Pom.Be.Ch/Pom/De/Index/Freiheitsentzug-Betreuung/Gefaengnisse/Bewachungsstationaminselspital/Medizin.Html'.] Last access: 03.09.2012
  16. Universitätsklinik für Allgemeine Innere Medizin, Jahresbericht 2010. In., vol. 2010. Bern: Inselspital Bern; 2010.
  17. Singleton N MH, Gatward R. Psychiatric Morbidity among Prisoners in England and Wales. London: Office for National Statistics; 1998.
  18. Fox KC, Somes GW, Waters TM. Timeliness and access to healthcare services via telemedicine for adolescents in state correctional facilities. The Journal of adolescent health: official publication of the Society for Adolescent Medicine 2007;41(2):161–7.
  19. Ellis DG, Mayrose J, Phelan M. Consultation times in emergency telemedicine using realtime videoconferencing. J Telemed Telecare. 2006;12(6):303–5.
  20. Meystre S. The current state of telemonitoring: a comment on the literature. Telemedicine journal and e-health: the official journal of the American Telemedicine Association 2005;11(1):63–9.
  21. Rabe K. Prison structure, inmate mortality and suicide risk in Europe. Int J Law Psychiatry. 2012;35(3):222–30.
  22. Metzner J.L. MRD, Kleinsasser D. Mental health screening and evaluation within prisons. Bulletin of the Academy of Psychiatry and Law. 1994;22:451–7.
  23. Davies SF. A hospital driven telepsychiatry initiative to improve patient care and reduce costs. North Carolina medical journal. 2012;73(3):228–30.

Most read articles by the same author(s)