Health incarcerated the use of medical services within correctional facilities.

Background: In order to adequately staff correctional medical teams it is important to collect objective data on their work load, especially given the increasing call for cut-backs in the overall treatment of inmates. Moreover, inmates typically constitute a vulnerable patient group, characterized by elevated levels of both physical and psychiatric symptoms. The aim of this study was to determine the work load of nurses and general practitioners employed within correctional facilities, and to determine the effect of possible correlates, such as inmate demographics, background, and diagnosis. Methods: During a one- or two-week period, each nurse and general practitioner within 17 Dutch correctional institutions (about 30% of all such institutions in The Netherlands) was asked to register all medical contacts with inmates. A total of 5602 registration forms were returned by 123 nurses (88.6%) and 36 general practitioners (94.7%). Multilevel analyses were used to control for design effects. Results: Preliminary results indicate that nurses have 20 contacts per inmate per year (18 with male inmates, 25.1 with female inmates). For general practitioners in the institutions this number is 6.4 (5.9 with males, 10.8 with females). Average length of the contacts was 7.5 minutes for nurses, and 7.1 min for general practitioners. It was found that drug addiction and psychiatric care was related with longer contact duration (up to 9.2 min). Conclusions Results clearly indicate the high intensity of medical work in prisons. When compared to another vulnerable patient group, asylum seekers (six contacts per patient per year), the number of contacts among correctional nurses were more than three times higher. To a lesser degree, the same applies for general practitioner in correctional institutions. Compared to practitioners within general health care (i.e. 3.94) contact rates were more than 50% higher. Gender and psychiatric or drug-related problems are correlates to elevated work load for correctional medical facilities. (aut.ref.)