How health care reform can transform the health of criminal justice-involved individuals.

Provisions of the Affordable Care Act offer new opportunities to apply a public health and medical perspective to the complex relationship between involvement in the criminal justice system and the existence of fundamental health disparities. Incarceration can cause harm to individual and community health, but prisons and jails also hold enormous potential to play an active and beneficial role in the health care system and, ultimately, to improving health. Traditionally, incarcerated populations have been incorrectly viewed as isolated and self-contained communities with only peripheral importance to the public health at large.

Paying the price: the pressing need for quality, cost, and outcomes data to improve correctional health care for older prisoners.

Despite a recent decline in the U.S. prison population, the older prisoner population is growing rapidly.

Aging in correctional custody: setting a policy agenda for older prisoner health care.

An exponential rise in the number of older prisoners is creating new and costly challenges for the criminal justice system, state economies, and communities to which older former prisoners return. We convened a meeting of 29 national experts in correctional health care, academic medicine, nursing, and civil rights to identify knowledge gaps and to propose a policy agenda to improve the care of older prisoners. The group identified 9 priority areas to be addressed: definition of the older prisoner, correctional staff training, definition of functional impairment in prison, recognition and assessment of dementia, recognition of the special needs of older women prisoners, geriatric housing units, issues for older adults upon release, medical early release, and prison-based palliative medicine programs.

Independent review of clinical health services for prisoners.

Purpose: The purpose of this paper is to describe the parameters for the development of performance measurement of the quality of medical care behind bars, drawing from widely-published free-world clinical guidelines and aspects of care that are unique to the criminal justice arena.

Design/methodology/approach: One way to help assure that prisoners receive timely and appropriate health care is through independent review of health care services, to identify strengths of programs and opportunities for improvement. This is a quality of medical care assessment.

Patient safety: moving the bar in prison health care standards.

Improvements in community health care quality through error reduction have been slow to transfer to correctional settings. We convened a panel of correctional experts, which recommended 60 patient safety standards focusing on such issues as creating safety cultures at organizational, supervisory, and staff levels through changes to policy and training and by ensuring staff competency, reducing medication errors, encouraging the seamless transfer of information between and within practice settings, and developing mechanisms to detect errors or near misses and to shift the emphasis from blaming staff to fixing systems. To our knowledge, this is the first published set of standards focusing on patient safety in prisons, adapted from the emerging literature on quality improvement in the community.

Tuberculosis control: lessons for outbreak preparedness in correctional facilities.

Correctional facilities typically house large numbers of persons in close and crowded conditions for long periods. Clusters of communicable diseases ranging from simple viral upper respiratory infections to more serious threats, such as tuberculosis (TB), infections with methicillin-resistant Staphylococcus aureus, and influenza, often emerge in these surroundings. The recent H1N1 influenza pandemic highlights the importance of outbreak prevention and containment preparedness, particularly in congregate settings.

Parole revocation among prison inmates with psychiatric and substance use disorders.

Objective: This retrospective cohort study examined the association between co-occurring serious mental illness and substance use disorders and parole revocation among inmates from the Texas Department of Criminal Justice, the nation's largest state prison system.

Methods: The study population included all 8,149 inmates who were released under parole supervision between September 1, 2006, and November 31, 2006. An electronic database was used to identify inmates whose parole was revoked within 12 months of their release.

Mental health performance measurement in corrections.

Correctional facilities have become, by default, one of the largest providers of mental health care for patients with serious mental illness. In its 2002 Report to Congress, the National Commission on Correctional Health Care has reported that most facilities do not provide quality mental health care, nor do they conform to nationally accepted guidelines for mental health screening and treatment. This article describes the product of a consensus panel of correctional health care experts, charged to develop performance measures, based on nationally accepted standards, for selected elements of psychiatric treatment behind bars, aimed to improve the quality of care.

Successful reentry: the perspective of private correctional health care providers.

Due to public health and safety concerns, discharge planning is increasingly prioritized by correctional systems when preparing prisoners for their reintegration into the community. Annually, private correctional health care vendors provide $3 billion of health care services to inmates in correctional facilities throughout the U.S.

Cost-effectiveness of universal screening for chlamydia and gonorrhea in US jails.

Universal screening for the sexually transmitted diseases (STDs) of chlamydia and gonorrhea on intake in jails has been proposed as the most effective strategy to decrease morbidity in inmates and to reduce transmission risk in communities after release. Most inmates come from a population that is at elevated risk for STDs and has limited access to health care. However, limited resources and competing priorities force decision makers to consider the cost of screening programs in comparison to other needs.