Magazine article Corrections Forum

Advancements in Corrections Medical Care

Magazine article Corrections Forum

Advancements in Corrections Medical Care

Article excerpt

With the advent of telemedicine, outsourcing medical care, geriatric care and computer technology, overall health care for inmate populations has undergone a drastic change in the past five years.

The court system and the medical profession have instigated health care reforms in correctional institutions. The increasing number of inmates today has stretched health care resources. More geriatric inmates than ever are incarcerated today, increasing the need for medical attention specifically to their needs.

Computer technology has improved the type and quality of healthcare available to prisoners-specialists are available for consultation via telemedicine, resulting in a reduction in the number of inmates leaving facilities for outside medical care. Inmates are also able to be treated sooner with easier access to specialists via telemedicine. Further, inmates' medical records are being computerized in some states, providing a more comprehensive and complete look at their medical history and health care.

Corrections health care issues and innovations vary widely, from continuing teamwork between corrections agencies and public health care agencies, to the high cost of hospital stays and medical specialist consultations to the impact of sicker inmates on corrections budgets.

Integration of Public Health

Integration of Public Health

"One of the biggest trends is in sharing the burden of treating inmates, with public health care agencies, corrections agencies and corresponding county and state health departments," says Edward Harrison, president of the National Commission on Correctional Health Care (NCCHC), Chicago, Ill. "We have a new surgeon general who once worked in jails and who has shown an interest in the role public agencies have and the role they can have in corrections healthcare. There has been a longstanding separation of corrections from government and public health agencies. Corrections is part of public health-federal agencies, the surgeon general, Congress and local authorities are trying to integrate public health."

Inmates have the right to receive medical care, but the cost of hospital stays and consultations with medical specialists is draining corrections budgets, according to Phil Dorsey, the director of managed correctional healthcare for Texas Tech University Health Science Center (TTUHSC), Lubbock, Tex., which provides medical care in western Texas to inmates in the Texas Department of Criminal Justice.

TTUHSC provides outpatient medical services at correctional facilities. It serves about 32,000 adult inmates at western Texas state and county jails and 1,100 juvenile inmates. It also maintains a 550-bed psychiatric hospital in Lubbock, within the walls of a corrections facility there, as well as a 108-bed acute care facility/regional medical center. Surgeries on inmates are performed at Texas Tech University Medical Center, and TTUHSC also maintains arrangements with local hospitals for offsite inmate medical care.

Dorsey notes that this arrangement with local hospitals has helped some of them keep their doors open for business. Specialized treatment programs have been developed at some units for inmates with high-cost medical conditions, such as AIDS, Hepatitis C, psychiatric disorders, mobility impairments and pregnancy.

The contract with TTUHSC has achieved substantial lower health care costs per inmate since the inception of the program. Improved utilization management, reduction in pharmacy costs, and the expanded use of telemedicine have all helped reduce inmate medical costs in western Texas.

"We're essentially like a large HMO for prisoners in western Texas," says Dorsey. "We're responsible for all of their medical care."

Another issue in corrections healthcare is a higher acuity in the patients. Inmates, on a whole, are sicker, partly because of the prevalence of Hepatitis C and HIV.

NCCHC's Harrison cites the conflict in Iraq as an issue in corrections healthcare because it has drained key medical personnel from correctional facilities, and it is also causing a reduction in state budgets. …

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