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Facilitators and Barriers to Continuing Healthcare After Jail: A Community-integrated Program

Lincoln, Thomas MD; Kennedy, Sofia MPH; Tuthill, Robert PhD; Roberts, Cheryl MPA; Conklin, Thomas J. MD; Hammett, Theodore M. PhD

Journal of Ambulatory Care Management: January-March 2006 - Volume 29 - Issue 1 - p 2–16

A cooperative, community-oriented “public health model of correctional healthcare”  was developed to address the needs of persons temporarily displaced into jail from the community, and to improve the health and safety of the community. It emphasizes 5 key elements: early detection, effective treatment, education, prevention, and continuity of care. In the program, physicians and case managers are “dually based”—they work both at the jail and at community healthcare centers. This, together with discharge planning, promotes continuity of care for inmates with serious and chronic medical conditions. This report characterizes the health status and healthcare in this group, and identifies facilitators and barriers to engagement in primary medical and mental health care after release from jail.

Baystate Medical Center, Springfield (Dr Lincoln), Hampden County Correctional Center, Ludlow (Drs Lincoln and Conklin), Abt Associates Inc, Cambridge (Mss Kennedy and Roberts and Dr Hammett), School of Public Health and Health Sciences, University of Massachusetts, Amherst (Dr Tuthill), Mass.

Corresponding author: Thomas Lincoln, MD, Baystate Medical Center, 759 Chestnut St, Springfield, MA 01199 (e-mail:

The evaluation of Hampden County's public health model of correctional healthcare was funded through the Hampden County Sheriff's Department, Baystate Medical Center, and grants from the National Institute of Justice, the Centers for Disease Control and Prevention, and the Center on Crime, Communities, and Culture of the Open Society Institute. We also thank the participants, including healthcare staff and patients, who shared their time and experience. Views expressed are those of the authors and not necessarily the supporting institutions.

© 2006 Lippincott Williams & Wilkins, Inc.