Diabetic events occurring during court hearings previously required emergency medical services (EMS) transport to the emergency department (ED). A new process was implemented whereby the provincial court (PC) was notified by the detention center of diabetes status of prisoners scheduled for court later that day, enabling a community nursing services provider to provide on-site diabetes assessment and treatment at the PC. During the 13-month pre-implementation phase, there were 10 incidents of diabetic distress resulting in an ED visit at a total cost of $797.58/prisoner, including police service personnel, EMS, and ED staff/physician. During the 12.5-month postimplementation phase, insulin was administered on-site during 72 court dates at a cost of $161.93/prisoner. The new process for managing diabetic needs of prisoners during court dates resulted in a substantial cost savings in terms of police services and health care personnel and improved the immediacy and quality of care for prisoners.
AgozinoB., VolpeS. L. (2009). Health inequalities in correctional institutions: Implications for health inequalities in the community. Journal of Correctional Health Care, 15, 251–267.
2.
American Diabetes Association. (2014). Diabetes management in correctional institutions. Diabetes Care, 37, S104–S111.
3.
BraatvedtG., RowanJ., AtherfoldC. (1994). A cross-sectional study of diabetes in Mt Eden Prison, Auckland. New Zealand Medical Journal, 107, 292–293.
FirthC. L., SazieE., HedbergK., DrachL., MaherJ. (2015). Female inmates with diabetes: Results from changes in a prison food environment. Women’s Health Issues, 25, 732–738.
7.
GatesM. L., BradfordR. K. (2015). The impact of incarceration on obesity: Are prisoners with chronic diseases becoming overweight and obese during their confinement?. Journal of Obesity, 2015, 532468.
8.
GillG. V., MacFarlaneI. A. (1989). Problems of diabetics in prison. British Medical Journal, 298, 221–223.
9.
HarzkeA. J., BaillargeonJ. G., PruittS. L., PulvinoJ. S., PaarD. P., KelleyM. F. (2010). Prevalence of chronic medical conditions among inmates in the Texas prison system. Journal of Urban Health, 87, 486–503.
10.
HinataM., OnoM., MidorikawaS., NakanishiK. (2007). Metabolic improvement of male prisoners with type 2 diabetes in Fukushima Prison, Japan. Diabetes Research and Clinical Practice, 77, 327–332.
11.
HornungC. A., GreifingerR. B., GadreS. (2002). A projection model of the prevalence of selected chronic diseases in the inmate population. In National Commission on Correctional Health Care (Ed.), The health status of soon-to-be-released inmates: A report to Congress (Vol. 2, pp. 39–56). Chicago, IL: Author.
12.
KellerA. S., LinkR. N., BickellN. A., CharapM. H., KaletA. L., SchwartzM. D. (1993). Diabetic ketoacidosis in prisoners without access to insulin. Journal of the American Medical Association, 269, 619–621.
LaiS. W., ChangW. L., LiaoK. F. (2008). Assessment of health status among incarcerated men. American Journal of the Medical Sciences, 335, 465–468.
15.
LeddyM. A., SchulkinJ., PowerM. L. (2009). Consequences of high incarceration rate and high obesity prevalence on the prison system. Journal of Correctional Health Care, 15, 318–327.
16.
MacFarlaneI. A. (1996). The development of healthcare services for diabetic prisoners. Postgraduate Medical Journal, 72, 214–217.
17.
MacFarlaneI. A., GillG. V., MassonE., TuckerN. H. (1992). Diabetes in prison: Can good diabetic care be achieved?. British Medical Journal, 304, 152–155.
18.
Martinez-GonzalezN. A., BerchtoldP., UllmanK., BusatoA., EggerM. (2014). Integrated care programmes for adults with chronic conditions: A meta-review. International Journal for Quality in Health Care, 26, 561–570.
PetitJ. M., GuenfoudiM. P., VolatierS., RudoniS., VaillantG., HermantC.…BrunJ. M. (2001). Management of diabetes in French prisons: A cross-sectional study. Diabetic Medicine, 18, 47–50.
21.
RosenD. L., SchoenbachV. J., WohlD. A. (2008). All-cause and cause-specific mortality among men released from state prison, 1980–2005. American Journal of Public Health, 98, 2278–2284.
22.
RosenD. L., WohlD. A., SchoenbachV. J. (2011). All-cause and cause-specific mortality among black and white North Carolina state prisoners, 1995-2005. Annals of Epidemiology, 21, 719–726.
23.
WilsonJ. S., LeasureR. (1991). Cruel and unusual punishment: The health care of women in prison. Nurse Practitioner, 16, 32, 34, 36–39.
24.
YoungM., WatersB., FalconerT., O’RourkeP. (2005). Opportunities for health promotion in the Queensland women’s prison system. Australia and New Zealand Journal of Public Health, 29, 324–327.
