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Emergency department utilization by a jail population.

Patrick J Maher1, Adeyinka A Adedipe2, Benjamin L Sanders3

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|July 2, 2018
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Emergency department (ED) visits by incarcerated individuals are common, involving a younger, healthier population with fewer abnormal vital signs. Evaluating enhanced jail medical capabilities could improve care and reduce ED costs.

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Area of Science:

  • Public Health
  • Emergency Medicine
  • Health Services Research

Background:

  • Incarcerated individuals constitute a significant population facing unique healthcare challenges.
  • Limited research exists on emergency department (ED) care for this demographic.
  • This study describes the population of incarcerated individuals utilizing ED services from an urban jail.

Purpose of the Study:

  • To characterize the demographic and clinical features of incarcerated patients presenting to the ED.
  • To compare the healthcare utilization patterns of incarcerated patients with the general ED population.
  • To identify potential areas for improving care and reducing costs for this patient group.

Main Methods:

  • A cohort study design was employed, analyzing ED visits from a city jail in 2015.
  • Data collected included demographics, triage information, length of stay, diagnostic testing, diagnoses, and disposition.
  • Comparisons were made between incarcerated patients and the overall ED patient population.

Main Results:

  • Incarcerated patients represented 1.3% of the ED census, with 868 visits.
  • Compared to the general population, they were younger, healthier (lower Elixhauser scores), and had lower admission rates.
  • Incarcerated patients had more frequent laboratory and radiologic testing and longer ED lengths of stay.

Conclusions:

  • ED visits from jail involve a relatively young, healthy population with low rates of abnormal vital signs and admissions.
  • High ED costs and available jail medical resources suggest further investigation into enhanced jail medical capabilities.
  • Increased medical capabilities within jails may improve care and decrease ED utilization and associated costs.