title: Older jail inmates and community acute care use.
abstract: OBJECTIVE
  We examined older jail inmates' predetainment acute care use (emergency department or hospitalization in the 3 months before arrest) and their plans for using acute care after release.
  
  
  METHODS
  We performed a cross-sectional study of 247 jail inmates aged 55 years or older assessing sociodemographic characteristics, health, and geriatric conditions associated with predetainment and anticipated postrelease acute care use.
  
  
  RESULTS
  We found that 52% of older inmates reported predetainment acute care use and 47% planned to use the emergency department after release. In modified Poisson regression, homelessness was independently associated with predetainment use (relative risk = 1.42; 95% confidence interval = 1.10, 1.83) and having a primary care provider was inversely associated with planned use (relative risk = 0.69; 95% confidence interval = 0.53, 0.89).
  
  
  CONCLUSIONS
  The Affordable Care Act has expanded Medicaid eligibility to all persons leaving jail in an effort to decrease postrelease acute care use in this high-risk population. Jail-to-community transitional care models that address the health, geriatric, and social factors prevalent in older adults leaving jail, and that focus on linkages to housing and primary care, are needed to enhance the impact of the act on acute care use for this population.
authors.affiliation: Anna H. Chodos, Cyrus Ahalt, Irena Stijacic Cenzer, and Brie A. Williams are with the Division of Geriatrics, University of California, San Francisco. Janet Myers is with the Center for AIDS Prevention Studies, University of California, San Francisco. Joe Goldenson is with Jail Health Services, San Francisco Department of Public Health. Brie A. Williams is also with San Francisco VA Medical Center.
authors.forename: Anna H
authors.initials: AH
authors.lastname: Chodos
authors.forename: Cyrus
authors.initials: C
authors.lastname: Ahalt
authors.forename: Irena Stijacic
authors.initials: IS
authors.lastname: Cenzer
authors.forename: Janet
authors.initials: J
authors.lastname: Myers
authors.forename: Joe
authors.initials: J
authors.lastname: Goldenson
authors.forename: Brie A
authors.initials: BA
authors.lastname: Williams
mesh_terms: D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment; D015438:Health Behavior; D006304:Health Status; D006703:Ill-Housed Persons; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011329:Prisoners / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013997:Time Factors