Incarceration and hospital care.
Risk for jail or prison recidivism is well documented among incarcerated individuals with schizophrenia. However, it is less clear that risk is also high for psychiatric hospital readmission after accounting for mediating influences such as psychopathology severity, functioning level, substance misuse, and demographic characteristics. Relative to counterparts without prior time in jail, this study therefore assessed whether formerly incarcerated individuals with schizophrenia were more likely to repeatedly use hospital care after controlling for level of functioning and symptomatology. Among 315 inpatients, former inmates had a greater mean number of previous hospital stays than other patients (t = -2.13; df = 305; p = 0.03) and were more likely to visit the emergency room or be rehospitalized within 3 months of discharge (chi2 = 8.83; df = 1; p = 0.003). They were twice as likely to be readmitted, moreover, even after accounting in logistic regression for age, sex, race, global functioning, psychopathology severity, alcohol abuse or dependence, and drug abuse or dependence (OR = .49; CI = .26-.95). Implications for community care are discussed, and the suggestion is made that jail diversion programs should be renamed and refocused as "jail and hospital diversion."
Prince
Jonathan D
JD
School of Social Work, Rutgers: The State University of New Jersey, New Brunswick, New Jersey, USA.
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003416:Criminal Law / Q000379:methods; D017831:Diagnosis, Dual (Psychiatry); D004637:Emergency Services, Psychiatric; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission; D011329:Prisoners / Q000331:legislation & jurisprudence / Q000523:psychology / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012926:Social Control, Formal / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology