title: Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: prospective cohort study.
abstract: OBJECTIVE
  To describe the association between ex-prisoner primary care physician contact within 1 month of prison release and health service utilisation in the 6 months following release.
  
  
  METHODS
  A cohort from the Passports study with a mean follow-up of 219 (± 44) days postrelease. Associations were assessed using a multivariate Andersen-Gill model, controlling for a range of other factors.
  
  
  METHODS
  Face-to-face, baseline interviews were conducted in a sample of prisoners within 6 weeks of expected release from seven prisons in Queensland, Australia, from 2008 to 2010, with telephone follow-up interviews 1, 3 and 6 months postrelease.
  
  
  METHODS
  From an original population-based sample of 1325 sentenced adult (≥ 18 years) prisoners, 478 participants were excluded due to not being released from prison during follow-up (n=7, 0.5%), loss to follow-up (n=257, 19.4%), or lacking exposure data (n=214, 16.2%). A total of 847 (63.9%) participants were included in the analyses.
  
  
  METHODS
  Primary care physician contact within 1 month of follow-up as a dichotomous measure.
  
  
  METHODS
  Adjusted time-to-event hazard rates for hospital, mental health, alcohol and other drug and subsequent primary care physician service utilisations assessed as multiple failure time-interval data.
  
  
  RESULTS
  Primary care physician contact prevalence within 1 month of follow-up was 46.5%. One-month primary care physician contact was positively associated with hospital (adjusted HR (AHR)=2.07; 95% CI 1.39 to 3.09), mental health (AHR=1.65; 95% CI 1.24 to 2.19), alcohol and other drug (AHR=1.48; 95% CI 1.15 to 1.90) and subsequent primary care physician service utilisation (AHR=1.47; 95% CI 1.26 to 1.72) over 6 months of follow-up.
  
  
  CONCLUSIONS
  Engagement with primary care physician services soon after prison release increases health service utilisation during the critical community transition period for ex-prisoners.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry (ACTRN12608000232336).
authors.affiliation: Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Western Australia, Australia Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.
authors.forename: Jesse T
authors.identifier: http://orcid.org/0000-0001-5702-372X
authors.initials: JT
authors.lastname: Young
authors.affiliation: Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Western Australia, Australia General Practice and Primary Health Care Research, School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Diane
authors.initials: D
authors.lastname: Arnold-Reed
authors.affiliation: Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Preen
authors.affiliation: Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Western Australia, Australia Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Max
authors.initials: M
authors.lastname: Bulsara
authors.affiliation: Queensland Centre for Intellectual and Developmental Disability, School of Medicine, The University of Queensland, Mater Misericordiae Hospital, South Brisbane, Queensland, Australia.
authors.forename: Nick
authors.initials: N
authors.lastname: Lennox
authors.affiliation: Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia School of Medicine, the University of Queensland, Herston, Queensland, Australia School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria, Australia Murdoch Children's Research Institute, Parkville, Victoria, Australia.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Kinner
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D001315:Australia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D058007:Physicians, Primary Care; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D013997:Time Factors
keywords: GENERAL PRACTITIONER; HEALTH SERVICES; PHYSICIANS; PRIMARY CARE; PRISONERS; UTILISATION