Capturing perceptions: Prisoners assess their health services ‐ Australia, 2001 and 2004

Bringing experiences of healthcare in custody into quality improvement

Patient experience is an essential component of safe and high-quality healthcare, yet rarely examined in the context of carceral settings. This article describes a project undertaken by the Ontario Ministry of the Solicitor General to collect evidence and perspectives on how to bring patient experiences of healthcare services delivered in provincial correctional facilities into ongoing quality improvement work. We first conducted a scoping review and jurisdictional scan to learn from existing processes and experiences. We then engaged frontline healthcare providers delivering services in custody and people with recent experience of incarceration regarding priority measures and processes for data collection and mechanisms for implementing evidence-based change. This article describes methods used to engage stakeholders, including a survey and focus groups, as well as key lessons learned. This work is relevant to readers experiencing barriers to patient engagement, interested in collaborative research processes, and developing services for people who have experienced incarceration.

Prisoners' perceptions of the healthcare service: A qualitative study

It is recognized that the health of those in prison is poorer than the general population. The objective of this research is to understand the perceptions of the prisoners of the health care that they received at a district level prison in Thailand. We conducted a qualitative study, using in-depth interviews. Content analysis was used for data analysis. The participants were 13 prisoners. The findings reveal the prisoners have positive attitudes toward health services. They think that they are receiving the same standard of care as the general population. However, they are concerned about getting a communicable disease and accessibility to emergency care. There is limited dental care. The female prisoners have more trouble accessing health care than male prisoners. Suggestions for solving the inequality of care for prisoners includes increasing the collaboration with the community hospitals, using telehealth, adding female health providers, and developing inmate health volunteers among the prisoners.

The prisoner as patient - a health services satisfaction survey

BACKGROUND

There is evidence for higher morbidity among prison inmates than in the general population. Despite this, patient satisfaction with the prison health services is scarcely investigated. The aim of the present study was to investigate patient satisfaction with prison health services in Norway and to analyze possible patient and service effects.

METHODS

The survey took part in 29 prisons in the southern and central part of Norway, representing 62% of the total prison capacity in Norway. A total of 1,150 prison inmates with prison health services experiences completed a satisfaction questionnaire (90% response rate). The patients' satisfaction was measured on a 12-item index. Multilevel analyses were used to analyze both patient and service characteristics as predictors of satisfaction.

RESULTS

The study revealed high levels of dissatisfaction with prison health services. There were substantial differences between services, with between-service-variance accounting for 9% of the total variance. Satisfaction was significantly associated with a senior staff member's evaluation of the health services possessing adequate resources and the quality of drug abuse treatment. At the patient level, satisfaction was significantly associated with older age, frequent consultations and better self-perceived health.

CONCLUSION

Prison inmates' satisfaction with the health services provided are low compared with patient satisfaction measured in other health areas. The substantial differences observed between services - even when adjusting for several known factors associated with patient satisfaction - indicate a potential for quality improvement.