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W\u00e4hrend die Prim\u00e4rversorgung in den Anstalten meist regelm\u00e4\u00dfig und teils sogar schneller als au\u00dferhalb gew\u00e4hrleistet ist, bleibt die Versorgung komplexerer Behandlungsbedarfe h\u00e4ufig auf wenige Justizvollzugskrankenh\u00e4user beschr\u00e4nkt. Strukturelle Defizite bestehen in der eingeschr\u00e4nkten freien Arztwahl, der limitierten spezial\u00e4rztlichen Versorgung, der Trennung vom regul\u00e4ren Gesundheitssystem sowie in Versorgungsl\u00fccken an den \u00dcberg\u00e4ngen zwischen Haft und Freiheit.<\/jats:p>\n                  <jats:p>Trotz des \u00c4quivalenzprinzips entspricht die intramurale Gesundheitsversorgung h\u00e4ufig nicht dem Standard der gesetzlichen Krankenversicherung (GKV). Eine Einbeziehung von Gefangenen in die GKV sowie eine Verantwortungs\u00fcbertragung auf Gesundheitsministerien werden international empfohlen und k\u00f6nnten die Versorgung verbessern.<\/jats:p>\n                  <jats:p>Besonders kritisch ist die Versorgung von Menschen mit Substanzgebrauchsst\u00f6rungen: Zugang zu evidenzbasierter Therapie ist l\u00fcckenhaft und regional sehr unterschiedlich. Auch Tabakentw\u00f6hnung und psychosoziale Hilfen sind unzureichend vorhanden. Auch Ern\u00e4hrung ist h\u00e4ufig unausgewogen, w\u00e4hrend Sport- und Bewegungsangebote bislang ungenutzt bleiben.<\/jats:p>\n                  <jats:p>Ein interdisziplin\u00e4res Versorgungskonzept im Sinne des \u201eHealthy-Prisons\u201c-Ansatzes fehlt bislang weitgehend. Das baden-w\u00fcrttembergische Modell mit Gesundheitsberichterstattung, telemedizinischen Ans\u00e4tzen, altersgerechter Versorgung und Qualit\u00e4tszirkeln k\u00f6nnte bundesweit als Vorbild dienen. Notwendig ist ein Paradigmenwechsel von der anstaltszentrierten F\u00fcrsorge hin zu partizipativer, pr\u00e4ventiver Gesundheitsf\u00f6rderung, die sowohl Gefangene als auch Bedienstete einbezieht.<\/jats:p>","DOI":"10.1007\/s00103-025-04137-y","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T09:07:09Z","timestamp":1762160829000},"page":"1424-1432","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gesundheits- und Risikoverhalten und riskante Verh\u00e4ltnisse: Gef\u00e4ngnis als Herausforderung der Gesundheitsversorgung","Health and risk behaviors and risky conditions: prison as a\u00a0challenge for healthcare provision"],"prefix":"10.1007","volume":"68","author":[{"given":"Heino","family":"St\u00f6ver","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulla-Britt","family":"Klankwarth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"4137_CR1","volume-title":"Gesundheitsversorgung in Haft","author":"K Keppler","year":"2024","unstructured":"Keppler\u00a0K, Lesting\u00a0W, St\u00f6ver\u00a0H (2024) Gesundheitsversorgung in Haft. 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