title: The Rikers Island Hot Spotters: Defining the Needs of the Most Frequently Incarcerated.
abstract: OBJECTIVE
  We used "hot spotting" to characterize the persons most frequently admitted to the New York City jail system in 2013.
  
  
  METHODS
  We used our Correctional Health Services electronic health record to identify 800 patients admitted in 2013 who returned most since November 2008. We compared them to a randomly selected control group of 800 others admitted in 2013, by using descriptive statistics and cross-tabulations, including data through December 2014.
  
  
  RESULTS
  The frequently incarcerated individuals had a median of 21 incarcerations (median duration 11 days), representing 18 713 admissions and $129 million in custody and health costs versus $38 million for the controls. The frequently incarcerated were significantly older (42 vs 35 years), and more likely to have serious mental illness (19% vs 8.5%) and homelessness (51.5% vs 14.7%) in their record. Significant substance use was highly prevalent (96.9% vs 55.6%). Most top criminal charges (88.7%) for the frequently incarcerated were misdemeanors; assault charges were less common (2.8% vs 10.4%).
  
  
  CONCLUSIONS
  Frequently incarcerated persons have chronic mental health and substance use problems, their charges are generally minor, and incarceration is costly. Tailored supportive housing is likely to be less costly and improve outcomes.
authors.affiliation: All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.
authors.forename: Ross
authors.initials: R
authors.lastname: MacDonald
authors.affiliation: All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.
authors.forename: Fatos
authors.initials: F
authors.lastname: Kaba
authors.affiliation: All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Rosner
authors.affiliation: All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.
authors.forename: Allison
authors.initials: A
authors.lastname: Vise
authors.affiliation: All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.
authors.forename: David
authors.initials: D
authors.lastname: Weiss
authors.affiliation: All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.
authors.forename: Mindy
authors.initials: M
authors.lastname: Brittner
authors.affiliation: All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.
authors.forename: Molly
authors.initials: M
authors.lastname: Skerker
authors.affiliation: All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Dickey
authors.affiliation: All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.
authors.forename: Homer
authors.initials: H
authors.lastname: Venters
mesh_terms: D000367:Age Factors; D002908:Chronic Disease; D003415:Crime / Q000706:statistics & numerical data; D057237:Criminals / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D009519:New York City; D011329:Prisoners; D011330:Prisons / Q000706:statistics & numerical data*; D044469:Racial Groups; D019966:Substance-Related Disorders / Q000453:epidemiology*