Prison hospital data removed from federal data set

Seeing it clear effect on health And this historical differences In the criminal legal system, it is more clear than ever that carnal health is critical to public health. Yet, we lack basic data about the health care being provided to the incarcerated population.

To assess the magnitude and distribution of a disease’s impact on a certain population, researchers often rely on health care data sets that provide information on patient hospitalizations. However, carceral data sets (those obtained from prisons or jails) often include very limited health-related information. Departments of Corrections (DOCs) are legally required to provide health care And fulfill this obligation through Hired or contracted medical services, referrals to community-based providers, DOC-managed prison hospitals, or some combination thereof. Health records generated and maintained by DOCs are not uniformly subject to public records requests, and statistical reports are rarely available through government websites; When DOC-reported carceral health information is available, it is not reported according to any standardized system. Relies on the only federal program dedicated to reporting the health of incarcerated populations survey based research publication Prepared by the Bureau of Justice Statistics.

Federal data sets to understand health care

Therefore, carceral health researchers and advocates are largely left to rely on data sources external to the criminal-legal system. One of the main sources of cancer health information is Healthcare Cost and Utilization Project (HCUP), a collection of databases which provides longitudinal data on the incidence of hospitalizations among approximately 4,500 participating hospitals across the United States. This includes hospital-level administrative data originally collected for billing purposes to provide insight into the provision of care, health care policy and costs, and health outcomes at varying geographic levels. this data set Represents the most comprehensive, publicly available information on state-by-state trends in the use of health care services, particularly among people who receive care in medical facilities. As a result, these data are fundamental to public health and are employed in a variety of research efforts, including those related to cancer health.

HCUP data is collected from organizations that partner and share information with the Agency for Healthcare Research and Quality (AHRQ). This voluntary arrangement provides the federal government with insight into health care provision. In turn, the federal government provides valuable analysis to partner organizations, often hospital trade groups or state health agencies, that can improve the quality of care. about 65 percent of american hospitals Data transmitted from the state to AHRQ are included. According to Online Training for HCUP Data Usage, these data sets exclude reports of hospitals managed (partially or wholly) by DOCs. While these data may not be published in HCUP, it is possible that they are collected from states and do not meet the AHRQ’s current inclusion criteria (as is the case with Long term care, psychiatric and chemical dependency treatment facilities, The extent to which data is collected by states from prison hospitals or transmitted to AHRQ is currently unknown.

To answer this question, we identified for each state (n = 19) that maintains health care facilities exclusively dedicated to the care of incarcerated patients (n = 28) (see Appendix below). (Community hospitals that treat incarcerated patients were not included in this analysis because care for these individuals may already be in the HCUP data collection.) We then contacted established authorities. HCUP Affiliate Organization Within these states to ask whether information from these care facilities was collected and transmitted to AHRQ. Correspondence with state-level agencies occurred between September and October of 2022, and responses were collected from all except the Texas Department of State Health Services (n = 18), which did not respond to our requests.

Where does the prison hospital data go?

Our inquiries with HCUP affiliates revealed that these agencies explicitly exclude data from prison hospitals in state data sets and subsequent federal reporting. For example, persons incarcerated in Virginia may be treated in one of two Secure Medical Units at community hospitals managed by the DOC (Medical College of Virginia Security Ward And Southampton Medical Center Secure Medical Unit, Yet, even these hospitals do not report health care data to the state. In one instance, the agency concerned was unaware that such a hospital was operating in their state. Elsewhere, reasons for not disseminating data included that the hospital was not licensed as such under the DOC jurisdiction (for example, Tennessee’s Lois M. DeBerry Special Needs FacilityAn inpatient health center that provides “acute and healthy care” for incarcerated patients is not a licensed hospital).

According to representatives from state agencies, the only data readily available to researchers pertains to whether individuals were treated at community hospitals through a variable in the hospital data set that indicates whether an individual was “treated.” Was recruited from law enforcement.” But this variable doesn’t tell researchers much because the web of “law enforcement” makes it impossible to distinguish whether a person was brought in by the police or from a jail, prison, or another cancer unit.

effect of default

While these 28 facilities represent only a small portion of the hospitals included in the HCUP inpatient data, they represent all self-identified prison hospital facilities. These omissions represent a fundamental failure to maintain agency mission, The AHRQ aims to improve the quality, access, and equity of care in the United States. more than 77 million Americans a criminal conviction has occurred – yet, notwithstanding the precedent established by Estelle vs Gamble While individuals experiencing incarceration have a constitutional right to health care that meets community standards, the absence of prison hospitals from federal health care data sets suggests that incarcerated patients receive the same health care as their non-incarcerated peers. Maintenance inspection is not received. Understanding the unique health needs of this community is an important and often overlooked health equity issue; This is essential if we are to understand whether cancer health standards are meeting community standards. If hospital care provided under the DOC is completely opaque, how can it be known whether the prison system is meeting its constitutional obligations?

Given the high burden of chronic conditions in incarcerated populations, health care metrics may not reflect the true needs of the public. Incorporating these communities into federal data sets will help understand health care spending, disease burden and workforce needs. tentative 95 percent of incarcerated people return to their communitieswith many poor health and new health conditions, If data from prison hospitals were accurately reflected in the HCUP, substantial interventions could be made by DOC and state health agencies to reduce the health decline observed in this population and subsequent burden on health care systems. to which they may eventually return. These goals can be realized without compromising the right to privacy of incarcerated patients, as the data are at the hospital level and prevent individual identification.

To promote health for all, it is critical that states include prison hospitals in their health data sets. Because HCUP is a voluntary partnership, there are few legislative levers to effect this change. Yet, a strength of HCUP, and other AHRQ programs, is the insight and analysis they provide to participating state partners. health care spending in the Federal Bureau of Prisons alone, is responsible for more than $1.34 billion in 2016, an increase of 36 percent in seven years. These expenses arise from the treatment of potentially preventable medical conditions that are not effectively managed because of the lack of much insight that HCUP exists to provide. Educating carceral administrators on the benefits of collaborating with HCUP partner organizations in their state can increase collaboration and, in turn, data transparency. This education may be facilitated through a partnership with the American Correctional Association, through advocacy within state budgetary authorities, or through some combination thereof. These groups are already in partnership with DOCs, and thus, are more likely to encourage change.

Through the oversight provided by voluntary participation in HCUP, AHRQ can more fully achieve its stated objectives that people who are incarcerated can receive better health care, and a more comprehensive understanding of American health care is gained. May go.

Contract, Carceral facilities that are inpatient care facilities operated by the state and jurisdiction’s respective HCUP partner organization for the specialized treatment of incarcerated persons

Source: authors’ findings.

authors note

The authors are supported by grants from the Langeloth Foundation and the Robert Wood Johnson Foundation.

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