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Mortality of hospitalized prisoners compared with other in-patients in a university hospital in Mashhad, Iran

Fereshte Sheybani, Mahnaz Arian, Nasrin Khosravi, Javad Rashid, Masoumeh Hoseini, Atefeh Behboudifar, Elaheh Eftekharpoor, HamidReza Naderi.

Purpose: Prisoners housed in overcrowded jails suffer increased rates of health problems, especially in regard to communicable diseases. If hospitalized, they become a threat to the staff and other patients by the transmission of pathogens, such as HIV and hepatitis viruses. Their higher mortality rate and the costs of their care, compared with other in-patients, are also of concern.
Methods: In this retrospective analytical study, the medical and cost-accounting records of all prisoners admitted over a period of 12 months, from March 2010 to March 2011, to the Imam Reza University Hospital in Mashhad, northeastern Iran, were reviewed.
Results: During this period, 65 106 patients were hospitalized, of whom only 390 (0.6%) were prisoners. Nevertheless, this group accounted for 1.7% of the annual hospital administrative costs. The average daily cost of a prisoner was 1.3 times that of the other in-patients. Moreover, the mortality rate for the prisoners was 12.7% compared with 5% for other in-patients (RR= 2.47).
Conclusions: The growing number of hospitalized prisoners have an unfavorable outcome but still incur considerable care costs. It therefore seems reasonable to look for substantial reform in the system of detention, screening and registration of prisoners with health problems as well as adhering to infection control measures, harm reduction and early diagnosis and referral to treatment facilities.

Key words: Prisoners; Care costs; In-patient mortality; Hospital Infection

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