title: Aging Prisoners in Switzerland: An analysis of Their Health Care Utilization.
abstract: OBJECTIVE
  This study assessed health care utilization of aging prisoners and compared it with that of younger prisoners.
  
  
  METHODS
  Health care utilization comprised visits to general practitioners (GPs), nurses, and mental health professionals (MHPs) for a period of 6 months. Using retrospective study design, data were extracted from medical records of 190 older prisoners (50 years and older) and 190 younger inmates (18-49 years). Age group was a dichotomous predictor variable with type of sentencing and time spent in prison as covariates. Descriptive statistics and generalized linear mixed models (GLMMs) were performed.
  
  
  RESULTS
  For each of the three outcome variables, two GLMMs were constructed. The first model only included age group as the predictor variable (3 × Unadjusted models). The second included the two covariates in addition to the predictor variable (3 × Adjusted model). Results from the adjusted model indicate that visits to GPs significantly differed between the two age groups (p = .022). Older prisoners visited GPs 1.43 times more often than younger prisoners over the 6-month period (adjusted risk ratio [RR] = 1.43, 95% confidence interval [CI] = [1.05, 1.94]). The finding for visits to nurses was not statistically significant (p = .080). However, older prisoners visited nurses 1.36 times more frequently (adjusted RR = 1.36, 95% CI = [0.96, 1.91]). Finally, older prisoners visited MHPs 1.24 times more often than younger prisoners (adjusted RR = 1.24, 95% CI = [.95, 1.61]) and this finding was also not statistically significant (p = .11).
  
  
  CONCLUSIONS
  Study findings underline that older prisoners utilized health care more often than younger prisoners although in most models the finding did not reach statistical significance. The prison system must develop solutions to address the needs of an aging population, particularly those with physical and mental health problems.
authors.affiliation: University of Basel, Switzerland tenzin.wangmo@unibas.ch.
authors.forename: Tenzin
authors.initials: T
authors.lastname: Wangmo
authors.affiliation: University of Basel, Switzerland.
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Meyer
authors.affiliation: University of Basel, Switzerland.
authors.forename: Violet
authors.initials: V
authors.lastname: Handtke
authors.affiliation: University of Basel, Switzerland.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Bretschneider
authors.affiliation: ZHAW Zurich University of Applied Sciences, Switzerland.
authors.forename: Julie
authors.initials: J
authors.lastname: Page
authors.affiliation: Forensic Psychiatrist, Bern, Switzerland.
authors.forename: Jens
authors.initials: J
authors.lastname: Sommer
authors.affiliation: University of Geneva, Switzerland.
authors.forename: Astrid
authors.initials: A
authors.lastname: Stuckelberger
authors.affiliation: University of Lausanne, Switzerland.
authors.forename: Marcelo F
authors.initials: MF
authors.lastname: Aebi
authors.affiliation: University of Basel, Switzerland.
authors.forename: Bernice S
authors.initials: BS
authors.lastname: Elger
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011329:Prisoners / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013557:Switzerland; D055815:Young Adult
keywords: aging in prison; health care utilization; older prisoners; prisoner