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Questionnaire to avoid transfers to healthcare: a Brazilian experience
Carlos Willie Alvarenga1, Luiz Henrique Fernandes1, Antonio Pazin-Filho1
1Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo , Ribeirão Preto, Brazil.
Abstract:
Purpose The purpose of this paper is to test whether training correctional facility (CF) officers in the admission process would identify risk factors for inmates' unscheduled transfers to healthcare units in the first 24 hours. Design/methodology/approach Correctional officers (COs) were trained to use a questionnaire with ten closed questions, which seeks to identify occupational or nosocomial risk, applied upon the admission of inmates to a CF. Findings There were 1,288 admissions in six CFs in Ribeirão Preto and Serra Azul/Brazil from March 2010 to May 2011. Of those admissions, 21.2 percent were in penitentiaries and 78.9 percent in provisional detention centers. Of the questionnaires applied, 580 answered affirmatively (45 percent) for one or more of the questions, with nearly 60 percent related to drug use in the last 12 hours, 37.7 percent use of medications while the most frequently mentioned diseases were respiratory diseases (37 percent) and mental disorders (19 percent).The number of positive responses per evaluation presented an odds ratio of 3.6 (CI 95% - 1.6, 10.5) for unscheduled transfers for external clinical evaluation. Research limitations/implications The lack of a control group and the fact that morbidities described by prisoners could not be confirmed are study limitations. The research does, however, still contribute to the goal of achieving appropriate medical care within CFs. Originality/value The training of COs to identify risk factors that predict the need for unplanned transfers to healthcare units was feasible. These findings have important implications for CFs that do not provide ongoing medical service, a universal reality in Brazil.
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