Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: Prospective cohort study

Jesse T Young, Dianne Arnold-Reed, David B Preen, Max Bulsara, Nick Lennox, Stuart Kinner

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34 Citations (Scopus)


Objective: To describe the association between ex-prisoner primary care physician contact within 1 month of prison release and health service utilisation in the 6 months following release.

Design: A cohort from the Passports study with a mean follow-up of 219 (?44) days postrelease. Associations were assessed using a multivariate Andersen-Gill model, controlling for a range of other factors.

Setting: Face-to-face, baseline interviews were conducted in a sample of prisoners within 6 weeks of expected release from seven prisons in Queensland, Australia, from 2008 to 2010, with telephone follow-up interviews 1, 3 and 6 months postrelease.

Participants: From an original population-based sample of 1325 sentenced adult (=18 years) prisoners, 478 participants were excluded due to not being released from prison during follow-up (n=7, 0.5 ), loss to follow-up (n=257, 19.4 ), or lacking exposure data (n=214, 16.2 ). A total of 847 (63.9 ) participants were included in the analyses.

Exposure: Primary care physician contact within 1 month of follow-up as a dichotomous measure.

Main outcome measures: Adjusted time-to-event hazard rates for hospital, mental health, alcohol and other drug and subsequent primary care physician service utilisations assessed as multiple failure time-interval data.

Results: Primary care physician contact prevalence within 1 month of follow-up was 46.5 . One-month primary care physician contact was positively associated with hospital (adjusted HR (AHR)=2.07; 95 CI 1.39 to 3.09), mental health (AHR=1.65; 95 CI 1.24 to 2.19), alcohol and other drug (AHR=1.48; 95 CI 1.15 to 1.90) and subsequent primary care physician service utilisation (AHR=1.47; 95 CI 1.26 to 1.72) over 6 months of follow-up.

Conclusions: Engagement with primary care physician services soon after prison release increases health service utilisation during the critical community transition period for ex-prisoners.
Original languageEnglish
Article numbere008021
Pages (from-to)1 - 11
Number of pages11
JournalBMJ Open
Issue number6
Publication statusPublished - 2015

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