Top

Published in:

01-08-2018

Six-Month Emergency Department Use among Older Adults Following Jail Incarceration

Authors: Jessi Humphreys, Cyrus Ahalt, Irena Stijacic-Cenzer, Eric Widera, Brie Williams

Published in: Journal of Urban Health | Issue 4/2018

Abstract

Although the number of older adults who are arrested and subject to incarceration in jail is rising dramatically, little is known about their emergency department (ED) use or the factors associated with that use. This lack of knowledge impairs the ability to design evidence-based approaches to care that would meet the needs of this population. This 6-month longitudinal study aimed to determine the frequency of 6-month ED use among 101 adults aged 55 or older enrolled while in jail and to identify factors associated with that use. The primary outcome was self-reported emergency department use within 6 months from baseline. Additional measures included baseline socio-demographics, physical and mental health conditions, geriatric factors (e.g., recent falls, incontinence, functional impairment, concern about post-release safety), symptoms (pain and other symptoms), and behavioral and social health risk factors (e.g., substance use disorders, recent homelessness). Chi-square tests were used to identify baseline factors associated with ED use over 6 months. Participants (average age 60) reported high rates of multimorbidity (61%), functional impairment (57%), pain (52%), serious mental illness (44%), recent homelessness (54%), and/or substance use disorders (69%). At 6 months, 46% had visited the ED at least once; 21% visited multiple times. Factors associated with ED use included multimorbidity (p = 0.01), functional impairment (p = 0.02), hepatitis C infection (p = 0.01), a recent fall (p = 0.03), pain (p < 0.001), loneliness (p = 0.04), and safety concerns (p = 0.01). In this population of older adults in a county jail, geriatric conditions and distressing symptoms were common and associated with 6-month community ED use. Jail is an important setting to develop geriatric care paradigms aimed at addressing comorbid medical, functional, and behavioral health needs and symptomatology in an effort to improve care and decrease ED use in the growing population of criminal justice-involved older adults.

Snyder HN, Mulako-Wangota J. Bureau of Justice statistics. (National estimates, annual tables, offense by age). Generated using the arrest data analysis tool at https://www.bjs.gov/index.cfm?ty=datool&surl=/arrests/index.cfm. Last accessed 22 Aug 2017.

Binswanger IA, Krueger PM, Steiner JF. Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general population. J Epidemiol Community Health. 2009;63(11):912–9. https://doi.org/10.1136/jech.2009.090662.CrossRefPubMed

Loeb SJ, Steffensmeier D, Lawrence F. Comparing incarcerated and community-dwelling older men’s health. West J Nurs Res. 2008;30(2):234–249; discussion 250-258. https://doi.org/10.1177/0193945907302981.CrossRefPubMed

Williams BA, McGuire J, Lindsay RG, et al. Coming home: health status and homelessness risk of older pre-release prisoners. J Gen Intern Med. 2010;25(10):1038–44. https://doi.org/10.1007/s11606-010-1416-8.CrossRefPubMedPubMedCentral

Binswanger IA, Stern MF, Deyo RA, et al. Release from prison—a high risk of death for former inmates. N Engl J Med. 2007;356(2):157–65. https://doi.org/10.1056/NEJMsa064115.CrossRefPubMedPubMedCentral

Subramanian R, et al. Incarceration’s front door: the misuse of jail in America. New York, NY: Vera Institute of Justice, 2015. Available online at: https://storage.googleapis.com/vera-web-assets/downloads/Publications/incarcerations-front-door-the-misuse-of-jails-in-america/legacy_downloads/incarcerations-front-door-report_02.pdf. Last accessed 22 Aug 2017.

Rich JD, Chandler R, Williams BA, et al. How health care reform can transform the health of criminal justice-involved individuals. Health Aff Proj Hope. 2014;33(3):462–7. https://doi.org/10.1377/hlthaff.2013.1133.CrossRef

Health and incarceration: a workshop summary. Washington, D.C.: National Academies Press; 2013. http://www.nap.edu/catalog/18372. Accessed 4 Aug 2016.

Liu B, Taylor DM, Ling SL-Y, MacGibbon P. Non-medical needs of older patients in the emergency department. Australas J Ageing. 2016; https://doi.org/10.1111/ajag.12265.

10.

Gruneir A, Silver MJ, Rochon PA. Emergency department use by older adults: a literature review on trends, appropriateness, and consequences of unmet health care needs. Med Care Res Rev MCRR. 2011;68(2):131–55. https://doi.org/10.1177/1077558710379422.CrossRefPubMed

11.

Samaras N, Chevalley T, Samaras D, Gold G. Older patients in the emergency department: a review. Ann Emerg Med. 2010;56(3):261–9. https://doi.org/10.1016/j.annemergmed.2010.04.015.CrossRefPubMed

12.

Ahalt C, Trestman RL, Rich JD, Greifinger RB, Williams BA. Paying the price: the pressing need for quality, cost, and outcomes data to improve correctional health care for older prisoners. J Am Geriatr Soc. 2013;61(11):2013–9. https://doi.org/10.1111/jgs.12510.CrossRefPubMedPubMedCentral

13.

Chodos AH, Ahalt C, Cenzer IS, Myers J, Goldenson J, Williams BA. Older jail inmates and community acute care use. Am J Public Health. 2014;104(9):1728–33. https://doi.org/10.2105/AJPH.2014.301952.CrossRefPubMedPubMedCentral

14.

Williams BA, Ahalt C, Stijacic-Cenzer I, Smith AK, Goldenson J, Ritchie CS. Pain behind bars: the epidemiology of pain in older jail inmates in a county jail. J Palliat Med. 2014;17(12):1336–43. https://doi.org/10.1089/jpm.2014.0160.CrossRefPubMedPubMedCentral

15.

Handtke V, Wolff H, Williams BA. The pains of imprisonment: challenging aspects of pain management in correctional settings. Pain Manag. 2016;6(2):133–6. https://doi.org/10.2217/pmt.15.62.CrossRefPubMed

16.

Williams BA, Lindquist K, Hill T, et al. Caregiving behind bars: correctional officer reports of disability in geriatric prisoners. J Am Geriatr Soc. 2009;57(7):1286–92.CrossRefPubMed

17.

Williams BA, Lindquist K, Sudore RL, Strupp HM, Willmott DJ, Walter LC. Being old and doing time: functional impairment and adverse experiences of geriatric female prisoners. J Am Geriatr Soc. 2006;54(4):702–7. https://doi.org/10.1111/j.1532-5415.2006.00662.x.CrossRefPubMed

18.

Noonan M, Rohloff H, Ginder S. Mortality in local jails and state prisons, 2000–2013 Statistical Tables. U.S. Department of Justice. Office of Justice Programs, Bureau of Justice Statistics; 2015. http://www.bjs.gov/content/pub/pdf/mljsp0013st.pdf. Accessed 11 Apr 2016.

19.

Bolano M, Ahalt C, Ritchie C, Stijacic Cenzer I, Williams B. Detained and distressed: persistent distressing symptoms in a population of older jail inmates. J Am Geriatr Soc. 2016;64:2349–55.CrossRefPubMedPubMedCentral

20.

Frank JW, Andrews CM, Green TC, Samuels AM, Trinh TT, Friedmann PD. Emergency department utilization among recently released prisoners: a retrospective cohort study. BMC Emerg Med. 2013;13:16. https://doi.org/10.1186/1471-227X-13-16.CrossRefPubMedPubMedCentral

21.

Frank JW, Linder JA, Becker WC, Fiellin DA, Wang EA. Increased hospital and emergency department utilization by individuals with recent criminal justice involvement: results of a national survey. J Gen Intern Med. 2014;29(9):1226–33. https://doi.org/10.1007/s11606-014-2877-y.CrossRefPubMedPubMedCentral

22.

Wang EA, Hong CS, Shavit S, Sanders R, Kessell E, Kushel MB. Engaging individuals recently released from prison into primary care: a randomized trial. Am J Public Health. 2012;102(9):e22–9. https://doi.org/10.2105/AJPH.2012.300894.CrossRefPubMedPubMedCentral

23.

Teixeira PA, Jordan AO, Zaller N, Shah D, Venters H. Health outcomes for HIV-infected persons released from the New York City jail system with a transitional care-coordination plan. Am J Public Health. 2015;105(2):351–7. https://doi.org/10.2105/AJPH.2014.302234.CrossRefPubMedPubMedCentral

24.

Freudenberg N. Jails, prisons, and the health of urban populations: a review of the impact of the correctional system on community health. J Urban Health Bull N Y Acad Med. 2001;78(2):214–35. https://doi.org/10.1093/jurban/78.2.214.CrossRef

25.

Hammett T, Roberts C, Kennedy S. Health-related issues in prisoner reentry. Crime Delinq. 2001;47:290–409.CrossRef

26.

Williams B, Abraldes R. Growing older: challenges of prison and reentry for the aging population. In: Greifinger RB, editor. Public Health behind Bars. New York: Springer; 2007. p. 56–72. http://link.springer.com/chapter/10.1007/978-0-387-71695-4_5. Accessed 11 Apr 2016.CrossRef

27.

Freudenberg N, Daniels J, Crum M, Perkins T, Richie BE. Coming home from jail: the social and health consequences of community reentry for women, male adolescents, and their families and communities. Am J Public Health. 2008;98(9 Suppl):S191–202.CrossRefPubMedPubMedCentral

28.

Lincoln T, Kennedy S, Tuthill R, Roberts C, Conklin TJ, Hammett TM. Facilitators and barriers to continuing healthcare after jail: a community-integrated program. J Ambul Care Manage. 2006;29(1):2–16.CrossRefPubMed

29.

Sudore RL, Landefeld CS, Williams BA, Barnes DE, Lindquist K, Schillinger D. Use of a modified informed consent process among vulnerable patients: a descriptive study. J Gen Intern Med. 2006;21(8):867–73. https://doi.org/10.1111/j.1525-1497.2006.00535.x.CrossRefPubMedPubMedCentral

30.

Quick guide to health literacy. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion; 2016. http://health.gov/communication/literacy/quickguide/quickguide.pdf. Accessed 11 Apr 2016.

31.

Hanson R, Letourneau E, Olver M, Miner M. Incentives for offender research participation are both ethical and practical. Crim Justice Behav. 2012;39:1391–404.CrossRef

32.

Maisto SA, Sobell LC, Sobell MB. Corroboration of drug abusers’ self-reports through the use of multiple data sources. Am J Drug Alcohol Abuse. 1982;9(3):301–8.CrossRefPubMed

33.

Hwang SW, Chambers C, Katic M. Accuracy of self-reported health care use in a population-based sample of homeless adults. Health Serv Res. 2016;51(1):282–301. https://doi.org/10.1111/1475-6773.12329.CrossRefPubMed

34.

Marquez M. Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH): defining “homeless” final rule. U.S. Department of Housing and Urban Development; 2011. https://www.hudexchange.info/resources/documents/HEARTH_HomelessDefinition_FinalRule.pdf. Accessed 11 Apr 2016.

35.

Growing older in America: health and retirement study: participant lifestyle questionnaire 2012. National Institute on Aging, National Institues of Health, U.S. Department of Health and Human Services; 2012. http://hrsonline.isr.umich.edu/modules/meta/2012/core/qnaire/online/HRS2012_SAQ_Final.pdf. Accessed 11 Apr 2016.

36.

Bush TL, Miller SR, Golden AL, Hale WE. Self-report and medical record report agreement of selected medical conditions in the elderly. Am J Public Health. 1989;79(11):1554–6.CrossRefPubMedPubMedCentral

37.

James DJ, Glaze LE. Mental health problems of prison and jail inmates. Bureau of Justice Statistics Special Report; 2006. http://www.bjs.gov/content/pub/pdf/mhppji.pdf. Accessed 11 Apr 2016.

38.

Skinner HA. The drug abuse screening test. Addict Behav. 1982;7(4):363–71.CrossRefPubMed

39.

Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789–95.CrossRefPubMed

40.

Portenoy RK, Thaler HT, Kornblith AB, et al. The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer Oxf Engl 1990. 1994;30A(9):1326–36.

41.

Merlin JS, Cen L, Praestgaard A, et al. Pain and physical and psychological symptoms in ambulatory HIV patients in the current treatment era. J Pain Symptom Manag. 2012;43(3):638–45. https://doi.org/10.1016/j.jpainsymman.2011.04.019.CrossRef

42.

Kroenke K, Spitzer RL, Williams JBW, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009;50(6):613–21. https://doi.org/10.1176/appi.psy.50.6.613.PubMedCrossRef

43.

Perissinotto CM, Stijacic Cenzer I, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Arch Intern Med. 2012;172(14):1078–83. https://doi.org/10.1001/archinternmed.2012.1993.CrossRefPubMedPubMedCentral

44.

Chochinov HM, Hassard T, McClement S, et al. The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care. J Pain Symptom Manag. 2008;36(6):559–71. https://doi.org/10.1016/j.jpainsymman.2007.12.018.CrossRef

45.

Vanhooren S, Leijssen M, Dezutter J. Loss of meaning as a predictor of distress in prison. Int J Offender Ther Comp Criminol. 2015; https://doi.org/10.1177/0306624X15621984.

46.

Marlow E. The impact of health care access on the community reintegration of male parolees. In: Presentation: 42nd annual communicating nursing research conference. Salt Lake City: Western Institute of Nursing; 2008.

47.

Adler F, Mueller G, Laufer W. Criminology and the criminal justice system. Chapter 18: A research focus on corrections in criminology and the criminal justice system. In: 6th ed. New York: McGraw-Hill; 2006.

48.

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. https://doi.org/10.1016/j.jbi.2008.08.010.CrossRefPubMed

49.

Smith AK, McCarthy E, Weber E, et al. Half of older Americans seen in emergency department in last month of life; most admitted to hospital, and many die there. Health Aff (Millwood). 2012;31(6):1277–85.CrossRef

50.

Brown RT, Kiely DK, Bharel M, Mitchell SL. Geriatric syndromes in older homeless adults. J Gen Intern Med. 2012;27(1):16–22.CrossRefPubMed

51.

National Center for Health Statistics. Health, United States, 2016: With chartbook on long-term trends in health. Table 74: emergency departments visits within the past 12 months among adults aged 18 and over, by selected characteristics: United States, selected years 1997-2015. Hyattsville, Maryland. 2017. Available online from: https://www.cdc.gov/nchs/data/hus/2016/074.pdf. Last accessed 22 Aug 2017.

52.

Lee PG, Cigolle C, Blaum C. The co-occurrence of chronic diseases and geriatric syndromes: the health and retirement study. J Am Geriatr Soc. 2009;57:511–6.CrossRefPubMed

53.

Buurman BM, Hoogerduijn JG, de Haan RJ, Abu-Hanna A, Lagaay AM, Verhaar HJ, et al. Geriatric conditions in acutely hospitalized older patients: prevalence and one-year survival and functional decline. PLoS One. 2011;6(11):e26951.CrossRefPubMedPubMedCentral

54.

Morris V, Wagg A. Lower urinary tract symptoms, incontinence and falls in elderly people: time for an intervention study. Int J Clin Pract. 2007;61:320–3.CrossRefPubMed

55.

Blumenthal D, Chernof B, Fulmer T, Lumpkin J, Selberg J. Caring for high-need, high-cost patients—an urgent priority. N Engl J Med. July 2016; https://doi.org/10.1056/NEJMp1608511.

56.

Sawyer P, Bodner EV, Ritchie CS, Allman RM. Pain and pain medication use in community-dwelling older adults. Am J Geriatr Pharmacother. 2006;4(4):316–24. https://doi.org/10.1016/j.amjopharm.2006.12.005.CrossRefPubMed

57.

Sun VK, Stijacic Cenzer I, Kao H, Ahalt C, Williams BA. How safe is your neighborhood? Perceived neighborhood safety and functional decline in older adults. J Gen Intern Med. 2012;27(5):541–7. https://doi.org/10.1007/s11606-011-1943-y.CrossRefPubMed

58.

Rich JD, Boutwell AE, Shield DC, et al. Attitudes and practices regarding the use of methadone in US state and federal prisons. J Urban Health Bull N Y Acad Med. 2005;82(3):411–9. https://doi.org/10.1093/jurban/jti072.CrossRef

59.

Rich JD, Allen SA, Williams BA. Responding to hepatitis C through the criminal justice system. N Engl J Med. 2014;370(20):1871–4. https://doi.org/10.1056/NEJMp1311941.CrossRefPubMed

60.

Iacomi F, Iannicelli G, Franceschini A, et al. HCV infected prisoners: should they be still considered a difficult to treat population? BMC Infect Dis. 2013;13:374. https://doi.org/10.1186/1471-2334-13-374.CrossRefPubMedPubMedCentral

61.

Spaulding AC, Thomas DL. Screening for HCV infection in jails. JAMA J Am Med Assoc. 2012;307(12):1259–60. https://doi.org/10.1001/jama.2012.374.CrossRef

62.

Varan AK, Mercer DW, Stein MS, Spaulding AC. Hepatitis C seroprevalence among prison inmates since 2001: still high but declining. Public Health Rep Wash DC 1974. 2014;129(2):187–95.

63.

Recommendations for the identification of chronic hepatitis c virus infection among persons born during 1945–1965. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6104a1.htm. Accessed 1 July 2016.

64.

Rich JD, Allen SA, Williams BA. The need for higher standards in correctional healthcare to improve public health. J Gen Intern Med. 2015;30(4):503–7. https://doi.org/10.1007/s11606-014-3142-0.CrossRefPubMed

65.

Finley DS, Brigham T. Creating a network of care: healthy San Francisco connects uninsured residents to a primary care home. Healthc Exec. 2011;26(3):72. 74-75PubMed

66.

Counsell SR, Callahan CM, Buttar AB, Clark DO, Frank KI. Geriatric Resources for Assessment and Care of Elders (GRACE): a new model of primary care for low-income seniors. J Am Geriatr Soc. 2006;54(7):1136–41. https://doi.org/10.1111/j.1532-5415.2006.00791.x.CrossRefPubMed

67.

Freeman RB. Can we close the revolving door? Recidivism vs. employment of ex-offenders in the U.S. In: Urban Institute Reentry Roundtable, Employment Dimensions of Reentry: Understanding the Nexus between Prisoner Reentry and Work. New York: New York University Law School; 2003.

Title: Six-Month Emergency Department Use among Older Adults Following Jail Incarceration
Authors: Jessi Humphreys
Cyrus Ahalt
Irena Stijacic-Cenzer
Eric Widera
Brie Williams
Publication date: 01-08-2018
Publisher: Springer US
Published in: Journal of Urban Health / Issue 4/2018
Print ISSN: 1099-3460
Electronic ISSN: 1468-2869
DOI: https://doi.org/10.1007/s11524-017-0208-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Six-Month Emergency Department Use among Older Adults Following Jail Incarceration

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2018

Assessment of Cardiovascular Health among Community-Dwelling Men with Incarceration History

Health Literacy Among a Formerly Incarcerated Population Using Data from the Transitions Clinic Network

Dissolution of Committed Partnerships during Incarceration and STI/HIV-Related Sexual Risk Behavior after Prison Release among African American Men

Food Insecurity, Morbidities, and Substance Use in Adults on Probation in Rhode Island

Exploring Lifetime Accumulation of Criminal Justice Involvement and Associated Health and Social Outcomes in a Community-Based Sample of Women who Use Drugs

HIV Care After Jail: Low Rates of Engagement in a Vulnerable Population