title: The preliminary experience in the emergency department of a newly opened penitentiary institution hospital in Turkey.
abstract: BACKGROUND
  Emergency cases become a widespread problem in prisons across Turkey. The opening of a new prison hospital in January 2012 within the catchment of Silivri Penitentiary Institution gave a unique opportunity to treat the inmates quickly.
  
  
  OBJECTIVE
  The study was to conduct an extensive review for documentation of prisoners' healthcare problems leading to emergency admission following the first year after the opening of Penitentiary Institution Hospital and point to decrease redundant hospital transfers of this individual cohort.
  
  
  METHODS
  A cross-sectional study was carried out where 12,325 visits to the Silivri Penitentiary Institution Hospital for emergency visits from the period of 1(st) January 2012 to the 31(st) December 2012 were identified from electronic medical records. After obtaining consent from the local IRB, data including details of the type, cause and nature of the complaints of the illnesses were processed.
  
  
  RESULTS
  In the 12-month period, there were 12,325 visits to the emergency department, of which 4328 for surgical conditions (35.1%), 2684 for medical disorders (21.8%), 1867 for sports injuries (15.2%), 1327 for Ear Nose Throat (ENT) problems (10.8%), 827 for psychiatric disorders (6.70%), 396 for violence injury (3.2%), 169 for self harm (1.4%), and 727 for miscellaneous (5.8%). The most common cause of emergency visits was sports injuries, followed by non-specific abdominal pain and ENT problems. Eighteen prisoners re-attended 243 times, ranging from 8 visits to a maximum of 56 visits.
  
  
  CONCLUSIONS
  Inmates in prison have a wide range of complaints, and sometimes these complaints do not suggest an illness. Prison population exhibited substantially higher prevalence rates of diseases than the civilian population. We conclude that this new healthcare system in prisons will prevent redundant hospital transfers and guarantee detainees have access to the same health care that is offered to non-detained population.
authors.affiliation: Department of Surgery, Silivri Penitentiary Institution Hospital, Silivri, Istanbul, Turkey.
authors.forename: Bora
authors.initials: B
authors.lastname: Koc
authors.affiliation: Department of Surgery, Silivri Penitentiary Institution Hospital, Silivri, Istanbul, Turkey.
authors.forename: Fırat
authors.initials: F
authors.lastname: Tutal
authors.affiliation: Department of Cardiology, Silivri Penitentiary Institution Hospital, Silivri, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Urumdas
authors.affiliation: Department of Cardiology, Silivri Penitentiary Institution Hospital, Silivri, Istanbul, Turkey.
authors.forename: Yalcın
authors.initials: Y
authors.lastname: Ozkurt
authors.affiliation: Department of Internal Disease, Silivri Penitentiary Institution Hospital, Silivri, Istanbul, Turkey.
authors.forename: Tugcan
authors.initials: T
authors.lastname: Erus
authors.affiliation: Departments of Radiology, Faculty of Medical, Yuzuncu Yil University, Van, Turkey.
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Yavuz
authors.affiliation: Department of Surgery, Faculty of Medical, Yuzuncu Yil University, Van, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Kemik
keywords: Emergency department; Inmates; Prison hospital