Emergency department utilization by a jail population

Am J Emerg Med. 2018 Sep;36(9):1631-1634. doi: 10.1016/j.ajem.2018.06.034. Epub 2018 Jun 19.

Abstract

Background: Incarcerated individuals represent a significant proportion of the US population and face unique healthcare challenges. Scarce articles have been published about emergency department (ED) care of these patients. We studied the ED visits from one urban jail to better describe this population.

Methods: A cohort study design was used, identifying patients who were sent to the ED from a city jail in 2015. Demographics, triage information, length of stay, number of studies, billing codes, diagnoses, and disposition data were collected. These were compared to the overall ED patient population in the same year.

Results: 868 ED visits by jail patients occurred, representing 1.3% of the ED census. Compared to the general population, incarcerated patients were younger (32.1 years vs. 44.0 years, p < .01), healthier based on Elixhauser comorbidity scores (0.71 vs. 0.98, p < .01), and had lower admission rates (11.29% vs. 21.54%, p < .01). An abnormal vital sign was noted in 25% of incarcerated patients. Laboratory (61% vs. 57%, p < .02) and radiologic (63% vs 45%, p < .001) testing was more frequent for inmates and length of stay was longer (271 vs. 225 min, p < .01).

Conclusion: ED visits from jail were common, involving a relatively young and healthy population with a low incidence of abnormal vital signs and admission. Given the high costs associated with ED care and the medical resources available at some jails, further study should evaluate if increased jail medical capabilities could improve care and decrease costs by decreasing ED visits.

Keywords: Emergency department; Incarcerated; Reducing unnecessary visits.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Prisoners / statistics & numerical data*
  • Prisons / statistics & numerical data
  • Urban Population / statistics & numerical data
  • Washington