The pivotal role of primary care in meeting the health needs of people recently released from prison.
OBJECTIVE
Australia's prison population is growing at a rate well in excess of population growth. Indigenous Australians are over-represented by a factor of 13. Prisoners are a profoundly marginalised group characterised by complex health and social needs. Despite improvements in health during incarceration, poor health outcomes after release are common, and the net effect of incarceration is usually health depleting. Given the need for effective care coordination, primary care plays a pivotal role in meeting the health needs of this population. In this paper we review what is known about patterns of primary care utilisation in ex-prisoners, identify evidence-based strategies for increasing access to primary care in ex-prisoners, and consider how such contact may shape subsequent health service outcomes.


CONCLUSIONS
Primary care is a necessary but not sufficient condition for effective post-release support. Positive outcomes may depend more on the quality than the quantity of care received. Given massive over-representation of Indigenous people in Australia's prisons, and compelling evidence of preventable morbidity and mortality after release from prison, effective models of care for this population are an important component of closing the gap in Indigenous life expectancy.
NHMRC Senior Research Fellow and Professor, Griffith Criminology Institute & Menzies Health Institute Queensland, Griffith University, Mt Gravatt, QLD, and; Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC and; QCIDD, Mater Research Institute-UQ, University of Queensland, Brisbane, QLD, and; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia s.kinner@griffith.edu.au.
Stuart A
SA
Kinner
Research Fellow and PhD Candidate, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC and; Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, WA; National Drug Research Institute, Curtin University, Perth, WA, Australia.
Jesse T
JT
Young
Research Fellow and PhD Candidate, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
Megan
M
Carroll
D001315:Australia / Q000453:epidemiology; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology / Q000628:therapy; D008603:Mental Health; D020380:Needs Assessment / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data; D011330:Prisons / Q000379:methods / Q000592:standards; D012917:Social Adjustment
case management; health services; mental health; primary health care; prisoners