Patient and hospitalization differences in incarcerated versus nonincarcerated men: Insights from a 10-year cohort study

Abstract

Background

The incarcerated population in the United States is underserved and aging rapidly; there is a dearth of information regarding their health, including hospital care. Epidemiological information is crucial to guide policymakers’ planning. This analysis provides comparison data on the admissions of incarcerated and nonincarcerated patients.

Objectives

Identify differences in inpatient care between incarcerated and nonincarcerated patients by comparing 10 years of data at an academic medical center that serves as the largest single provider of hospital care for the state's Department of Corrections.

Methods

Ten-year cohort study comparing all admissions of incarcerated males (n = 4525) to a matched cohort of nonincarcerated (n = 13,575) at an academic medical center serving as the largest provider of hospital care for the state's Department of Corrections. We included patients ≥18 years old and admitted to the hospital while in custody of the Department of Corrections between January 1, 2010, and December 31, 2019. Primary outcomes were patient characteristics, including demographics and comorbidities, and hospitalization characteristics, including length of stay and diagnosis.

Results

Compared with the nonincarcerated cohort, the incarcerated patients were more likely to be Black (33.4% vs. 6.6%, p < 0.05), Hispanic/Latine (6.1% vs. 2.1%, p < 0.001), admitted to a general medicine service (33.4% vs. 22.6%, p < 0.01), and less likely to be admitted to neurological/psychiatric services (5.2% vs. 9.1%, p < 0.01). The incarcerated cohort had a higher mean Charlson Comorbidity Index (3.83 vs. 3.65, p < 0.001), with statistically significant differences observed among patients aged 40–59.

Conclusion

In this cohort study, there were differences in patient and hospitalization characteristics between incarcerated and nonincarcerated patients that may have clinical implications. Policymakers and researchers must work toward improving both the health and health care of this marginalized population.