title: Patterns of older and younger prisoners' primary healthcare utilization in Switzerland.
abstract: Purpose The purpose of this paper is to identify primary health concerns prompting older and younger prisoners in Switzerland to consult a nurse or a general practitioner (GP) within the prison healthcare setting, and explores if these reasons for visits differ by age group (49 years and younger vs 50 years and older). The authors used 50 years and older as the benchmark for older prisoners in light of literature indicating accelerated aging among prisoners. Design/methodology/approach Retrospective information from medical records of 406 prisoners were collected for a period of six months. This study analyzed the reasons for which prisoners visited the nurses and GPs available to them through the prison healthcare service. These reasons were coded using the International Classification of Primary Care-version 2. Data were analyzed descriptively and four generalized linear models were built to examine whether there was an age group difference in reasons for visiting nurses and GPs. Findings The health reasons for visiting nurses and GPs by 380 male prisoners from 13 Swiss prisons are presented. In the six month period, a total of 3,309 reasons for visiting nurses and 1,648 reasons for visiting GPs were recorded. Prisoner participants' most common reasons for both visits were for general and unspecified complaints and musculoskeletal problems. Older prisoners sought significantly more consultations for cardiovascular and endocrine problems than younger prisoners. Research limitations/implications Nurses play an important role in addressing healthcare demands of prisoners and coordinating care in Swiss prisons. In light of age-related healthcare demands, continuing education and training of both nurses and GPs to adequately and efficiently address the needs of this prisoner group is critical. Allowing prisoners to carry out some care activities for minor self-manageable complaints will reduce the demand for healthcare. Originality/value This study presents unique data on healthcare concerns for which prisoners visit prison nurses and GPs. It highlights the varied needs of older prisoners as well as how these needs are addressed based on the availability of the primary healthcare provider within the prison.
authors.affiliation: Institute for Biomedical Ethics, University of Basel , Basel, Switzerland.
authors.forename: Tenzin
authors.initials: T
authors.lastname: Wangmo
authors.affiliation: Faculty of Medicine, University of Basel , Basel, Switzerland.
authors.forename: Sirin
authors.initials: S
authors.lastname: Hauri
authors.affiliation: Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel , Basel, Switzerland.
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Meyer
authors.affiliation: Institute for Biomedical Ethics, University of Basel , Basel, Switzerland.
authors.forename: Bernice S
authors.initials: BS
authors.lastname: Elger
mesh_terms: D017677:Age Distribution; D015897:Comorbidity; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology
keywords: Healthcare utilization; Older prisoners; Prison primary healthcare; Reasons for visits