Emergency department admissions to a prison hospital: a retrospective cohort study from Switzerland

INTRODUCTION: There are more than 10 million prison inmates throughout the world and this number is increasing continuously. Prisoners are a particularly vulnerable minority group that has special healthcare needs and demands on healthcare services and providers. The aim of this study was to give an overview of prisoners' healthcare problems leading to emergency department admission, in order to make recommendations to help to optimise treatment of this target group. METHODS: Our retrospective data analysis comprised adult (age >= 16 years) prisoners admitted to our emergency department, in transit to admission to our hospital-associated medical prison ward, between 2nd February 2000 and 30th April 2012. RESULTS: A total of 1703 patients were analysed. Of these, 78.2% (n = 1333) were male and 21.8% (n = 370) female. The mean age was 36.6 years (standard deviation 14.6, range 16-92 years). The most frequent reasons for presentation were psychiatric problems (43.4%; n = 739), followed by the need for medical treatment (31.6%; n = 539) and for surgical treatment (25.0%; n = 425). Patients with medical problems were significantly older than patients with psychiatric and surgical presentations (for both p < 0.001). Patients with psychiatric problems were significantly younger than those with medical or surgical problems (p < 0.001). A total of 130 (7.6%) of our patients were rehospitalised within the study period. CONCLUSION: Prisoners are a vulnerable minority group within our society with limited access to medical care. Transfer of information between the emergency department and prison staff should be promoted. Further research should be carried out on prisoners' healthcare problems.