AHRQ Innovations Exchange | Community-Based Clinic Enhances Access to Medical Care and Reduces Emergency Department Visits for Chronically Ill Recently Released Prisoners

Innovation Profile:

Community-Based Clinic Enhances Access to Medical Care and Reduces Emergency Department Visits for Chronically Ill Recently Released Prisoners

Snapshot
Back Story:
During his most recent 10-year term in a California state prison, Darryl was diagnosed with diabetes, hypertension and hyperlipidemia. Because prison nursing staff gave him all his medications and prison policy dictated his diet and physical activity, Darryl never learned to manage his chronic health conditions. When released from prison,...

Summary
The Transitions Clinic reaches out to individuals who have recently been released from prison who suffer from chronic health conditions, providing them with transitional and primary health care and case management services, including referrals to needed social services. Open two half-days a week, the clinic is staffed by trained community health workers who have experienced incarceration and by medical staff who show compassion and treat patients with dignity and respect. The program has increased access to medical care for recently released prisoners, as evidenced by increases in the number seeking medical care and by above-average attendance at their initial and followup appointments. It also has decreased emergency department visits as documented in a randomized controlled trial of emergency department use.

Evidence Rating
Strong: Evidence for care seeking behavior and a reduction in ED visits resulted from a randomized controlled trial (RCT) of 200 individuals, half assigned to the Transitions Clinic and half to another safety net clinic that did not provide case management services. Additional evidence consists of post-implementation data on the number of newly released individuals seeking care at the clinic and attendance rates for initial and followup clinic appointments (as compared to attendance rates for other, similar patients seen at the large health center in which the clinic operates).

Developing Organizations
San Francisco, CA

Date First Implemented
2006

Patient Population
Vulnerable Populations > Prisoners; Substance abusers; Urban populationsend pp

full-text:
AHRQ Innovations Exchange | Community-Based Clinic Enhances Access to Medical Care and Reduces Emergency Department Visits for Chronically Ill Recently Released Prisoners