In the neglected field of prison health research, jails constitute a doubly marginalized domain for evaluation and advocacy.

7 Unfortunately, data evaluating the delivery of medical services to inmates are sparse, particularly in jail settings. These challenges include discontinuity of care, 3 lack of timely access to medical records, lack of trust between patient and provider, 4 withdrawal from addictive substances, 5 poor discharge planning, 6 and loss of medical insurance.

Jails pose particular challenges to health care delivery because of the large volume and rapid turnover of inmates. Prisons hold sentenced inmates for periods of a year or longer jails confine pretrial detainees and inmates sentenced to periods of less than 1 year. In most states, the correctional system is 2-tiered, composed of prisons and jails.

The challenges of providing standard-of-care medical services to prisoners are manifold. A recent nationwide survey found high rates of medical and psychiatric conditions among US prisoners, with nearly 70% of inmates reporting at least 1 chronic illness. Delivering medical care to inmates and ensuring continuity of care after release are logistically complex and costly endeavors. 1 In fact, prisoners are the only civilian subgroup in the United States with a constitutionally guaranteed right to health care. In 1976, the US Supreme Court issued a landmark decision, Estelle v Gamble, granting prisoners a constitutional right to standard-of-care medical services. There was limited state oversight and coordination of county jail medical care. Jail medical services in New York State were heterogeneous and decentralized, provided mostly by local physician practices and correctional medical corporations. Larger, urban jails, with a greater proportion of Black and Hispanic inmates, tended to use public hospitals or correctional medical corporations as health care vendors.Ĭonclusions. In New York City, 90% of inmates received medical care from a correctional medical corporation. In counties outside New York City (n = 57), jail medical care was delivered by local providers in 40 counties (70%), correctional medical corporations in 8 counties (14%), and public providers in 9 counties (16%). We obtained data from state monitoring programs and e-mail questionnaires sent to county departments of health. From 2007 through 2009, we collected data on types of medical care providers for jail inmates in all New York State counties. We sought to characterize the primary medical care providers for county jail inmates in New York State. People who are incarcerated exhibit high rates of disease, but data evaluating the delivery of medical services to inmates are sparse, particularly for jail settings.

Coc prison mod