Healthcare utilization and patient engagement in women leaving jail or prison

Background: For women with chronic illnesses leaving incarceration, access to and engagement with the healthcare system is critical to successful reintegration. Public health nurses are uniquely qualified to intervene with women in transition. Methods: This analysis used baseline data from the WITH intervention study with women (N=72) living in a community corrections facility after release from jail or prison. Descriptive statistics were used to assess health, healthcare and patient engagement (measured using Patient Activation Measure); correlations and chi-square statistics were used to examine the relationships among variables.Results: Participants, ages 22-64, were mostly white (69%) with an average of 7.8 (SD 8.7) incarcerations. Sixty-nine (95.8%) of the women reported a substance abuse problem. Nearly 85% had health insurance; 65% reported having a PCP. 86.1% reported physical health problems, for which 72.2% took medications. Since release, 29.2% visited an ER, and 34.7% had routine care. Eighty-nine percent reported a mental health diagnosis; almost 60% reported seeing a mental health professional since release and 69.4% took psychiatric medications. Over 40% of the women were in the highest level of patient engagement. Engagement was only significantly associated with health insurance; higher levels of meant more likely to have insurance (p=.02). Conclusions: Levels of engagement for this population were high, and women accessed health services to some extent. Mental health appears to have a greater priority over physical. The high number of co-morbidities suggests the need for healthcare services is still significant; PHNs are ideally suited to provide services and help facilitate community connections.