Abstract
IMPORTANCE: Little is known about the risk of individuals who are released from correctional facilities, a time when there may be discontinuity in care. OBJECTIVE: To study the risk for hospitalizations among former inmates soon after their release from correctional facilities. DESIGN: Retrospective cohort study. PARTICIPANTS: Data from Medicare administrative claims for 110,419 fee-for-service beneficiaries who were released from a correctional facility from 2002 through 2010 and controls matched by age, sex, race, Medicare status, and residential zip code. MAIN OUTCOMES AND MEASURES: Hospitalization rates and specifically those for ambulatory care-sensitive conditions 7, 30, and 90 days after release. RESULTS: Of 110,419 released inmates, 1559 individuals (1.4%) were hospitalized within 7 days after release; 4285 individuals (3.9%) within 30 days; and 9196 (8.3%) within 90 days. The odds of hospitalization was higher for released inmates compared with those of matched controls (within 7 days: odds ratio [OR], 2.5 [95% CI, 2.3-2.8]; within 30 days: OR, 2.1 [95% CI, 2.0-2.2]; and within 90 days: OR, 1.8 [95% CI, 1.7-1.9]). Compared with matched controls, former inmates were more likely to be hospitalized for ambulatory care-sensitive conditions (within 7 days: OR, 1.7 [95% CI, 1.4-2.1]; within 30 days: OR, 1.6 [95% CI, 1.5-1.8]; and within 90 days: OR, 1.6 [95% CI, 1.5-1.7]). CONCLUSIONS AND RELEVANCE: About 1 in 70 former inmates are hospitalized for an acute condition within 7 days of release, and 1 in 12 by 90 days, a rate much higher than in the general population.