| Abstract: | Purpose: Inmates will be enrolled in Taiwan Second-Generation National Health Insurance (NHI) which is expected implemented in 2013. Since they were not enrolled in NHI, there is no data to forecast their medical utilizations and health status. Besides, there were only few inmates’ longitudinal studies in the past. Therefore, the research aimed to compare the inmates’ medical utilizations and health status before and after going jail, and explore the relative factors that influenced inmates’ medical utilizations.Method: This research was based on NHI database to find out the 11,582 study population who had not only been in jail during 2003-2004, and had left before 2007, but also had used medical services due to chronic diseases. The research was used descriptive statistics, chi-square, and paired t test to compare the inmates’ outpatient and inpatient medical utilizations before and after going jail. All the statistic analysis were conducted on SAS 9.1.Results: The male (87.4%) was much more than the female, and the most inmates’ age were between 25-44 years old (63.9%). The outpatient utilization after leaving prison was higher than going jail (11.3 times vs. 9.4 times), but there was no difference between inpatient utilization. The females’ outpatient utilization was higher than the males’, and older inmates’ medical utilization had higher growth. Dermatitis, drug abuse, hepatitis C, and chronic mental illness were common on inmates. The inmates suffered from hypertension and diabetics after leaving jail increased most, but suffered from dermatitis and drug abuse decreased. The medical utilization after leaving jail was increased most on the inmates who suffered from sexual diseases and middle and end-stageliver disease, but inmates with drug abuse was decreased. According to standardized regression coefficient, age, gender, drug abuse, dermatitis, hepatitis C, and heart disease were the relative factors that influenced inmates’ medical utilization before and after going jail.Conclusion: Not all of the inmates’ medical utilizations increased after leaving prison. In addition, the inmates’ medical utilizations decreased in some kind of diseases. However, the outpatient utilization was increased, but the inpatient utilization was decreased. The major factors that influenced inmates’ outpatient utilization after leaving prison were age, gender and drug abuse. According to the results, this research suggests that 1) the government should promote inmates’ health examination and training, emphasize healthcare of hypertension, diabetics, sexual diseases, mental illness and drug abuse, and concern on inmates’ aging problem. 2) Regarding the inmates’ demand of outpatient services, the planning of Second-Generation NHI about the inmates may be focused on general outpatient and specialties. |
