{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:29:30Z","timestamp":1791386970020,"version":"4.3.3"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2019,9,17]],"date-time":"2019-09-17T00:00:00Z","timestamp":1568678400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJEM"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec id=\"S1481803519004019_sec_a1\" sec-type=\"other\"><jats:title>Objectives<\/jats:title><jats:p>The aims of this study were to describe emergency department (ED) utilization by people in provincial prison and on release, and to compare with ED utilization for the general population.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803519004019_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>We linked correctional and health administrative data for people released from provincial prison in Ontario in 2010. We matched each person by age and sex with four people in the general population. We compared ED utilization rates using generalized estimating equations, by sex and for high urgency and ambulatory care sensitive conditions.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803519004019_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>People who experienced imprisonment (N = 48,861) had higher ED utilization rates compared with the general population (N = 195,444), with rate ratios of 3.2 (95% CI 3.0\u20134.4) for men and 6.5 (95% CI 5.6\u20137.5) for women in prison and a range of rate ratios between 3.1 and 7.7 for men and 4.2 and 8.8 for women over the 2 years after release. Most ED visits were high urgency, and between 1.0% and 5.1% of visits were for ambulatory care sensitive conditions. ED utilization rates increased on release from prison.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803519004019_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>People experiencing imprisonment in Ontario have higher ED utilization compared with matched people in the general population, primarily for urgent issues, and particularly in women and in the week after release. Providing high-quality ED care and implementing prison- and ED-based interventions could improve health for this population and prevent the need for ED use.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cem.2019.401","type":"journal-article","created":{"date-parts":[[2019,9,17]],"date-time":"2019-09-17T07:53:51Z","timestamp":1568706831000},"page":"232-240","source":"Crossref","is-referenced-by-count":15,"title":["Emergency department use in people who experience imprisonment in Ontario, Canada"],"prefix":"10.1007","volume":"22","author":[{"given":"John","family":"Tuinema","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M.","family":"Orkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Y.","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinwah","family":"Fung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6869-7516","authenticated-orcid":false,"given":"Fiona G.","family":"Kouyoumdjian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,9,17]]},"reference":[{"key":"S1481803519004019_ref18","doi-asserted-by":"publisher","DOI":"10.1080\/15412550903140865"},{"key":"S1481803519004019_ref36","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.151232"},{"key":"S1481803519004019_ref27","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1377\/hlthaff.12.1.162","article-title":"Impact of socioeconomic status on hospital use in New York City","volume":"12","author":"Billings","year":"1993","journal-title":"Health Aff"},{"key":"S1481803519004019_ref26","doi-asserted-by":"publisher","DOI":"10.1017\/S1481803500009428"},{"key":"S1481803519004019_ref31","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1144"},{"key":"S1481803519004019_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-017-0208-4"},{"key":"S1481803519004019_ref29","article-title":"Overlapping confidence intervals and statistical significance: Cornell University; 2008","author":"Knezevic","journal-title":"Available at"},{"key":"S1481803519004019_ref2","first-page":"215","article-title":"The health status of prisoners in Canada: a narrative review","volume":"62","author":"Kouyoumdjian","year":"2016","journal-title":"Can Fam Physician"},{"key":"S1481803519004019_ref13","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181adcbe9"},{"key":"S1481803519004019_ref9","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020897"},{"key":"S1481803519004019_ref23","article-title":"The Johns Hopkins ACG system; 2018","author":"Johns Hopkins","journal-title":"Available at"},{"key":"S1481803519004019_ref33","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13060"},{"key":"S1481803519004019_ref5","doi-asserted-by":"publisher","DOI":"10.1186\/1471-227X-13-16"},{"key":"S1481803519004019_ref21","first-page":"e18","article-title":"Accuracy of administrative databases in identifying patients with hypertension","volume":"1","author":"Tu","year":"2007","journal-title":"Open Med"},{"key":"S1481803519004019_ref35","doi-asserted-by":"publisher","DOI":"10.1186\/2194-7899-2-6"},{"key":"S1481803519004019_ref14","doi-asserted-by":"crossref","DOI":"10.1016\/j.amepre.2015.02.018","article-title":"Looking beyond income and education: socioeconomic status gradients among future high-cost users of health care","author":"Fitzpatrick","year":"2015","journal-title":"Am J Prev Med"},{"key":"S1481803519004019_ref20","doi-asserted-by":"crossref","first-page":"160","DOI":"10.24095\/hpcdp.33.3.06","article-title":"Identifying cases of congestive heart failure from administrative data: a validation study using primary care patient records","volume":"33","author":"Schultz","year":"2013","journal-title":"Chronic Dis Inj Can"},{"key":"S1481803519004019_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12054"},{"key":"S1481803519004019_ref12","volume-title":"International Agency for Research on Cancer","author":"Chong","year":"1998"},{"key":"S1481803519004019_ref6","unstructured":"Canadian Institutes for Health Research. 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