“No One Wants to Die Alone”: Incarcerated Patients' Knowledge and Attitudes About Early Medical Release

Deaths among incarcerated individuals have steadily increased in the U.S., exceeding 5000 in 2014. Nearly every state has a policy to allow patients with serious life-limiting illness to apply for release from prison or jail to die in the community (“early medical release”). Although studies show these policies are rarely used, patient-level barriers to their use are unknown.To assess incarcerated patients' knowledge of early medical release policies and to identify patient-level barriers to accessing these policies.A cross-sectional survey of 46 male patients in two state prisons and one large urban jail who had visited a primary care provider at least three times within three months was conducted.Participants' average age was 64 years, and 89% had more than one chronic illness. Fewer than half (43%) demonstrated the knowledge needed to apply for early medical release and 22% demonstrated no relevant knowledge. Participants with sufficient knowledge were significantly more likely to endorse anxiety (35% vs. 0%,  = .003) and loneliness (65% vs. 30%,  = .017).Many medically complex incarcerated patients in this study did not demonstrate sufficient knowledge to apply for early medical release suggesting that patient education may help expand access to these policies. Moreover, seriously ill patients with knowledge of early medical release may benefit from enhanced psychosocial support given their disproportionate burdens of anxiety and loneliness. Our findings highlight the pressing need for larger studies to assess whether improved patient education and support can expand access to early medical release.

在美国，继承的人的死亡人数在2014年悄悄地增加了。几乎每个州都有一项政策，允许患有严重生命的疾病的患者申请从监狱或监狱中释放的患者在社区中死亡（“早期医疗发布”，尽管这些政策表明这些政策很少使用，患者级别的障碍是无名的。并确定访问这些政策的患者级别的障碍。对两个州监狱中的46名男性患者和一个大型城市监狱的横截面调查至少在三个月内访问了三次，参与者的平均年龄为64岁。知识。鉴于他们的焦虑和孤独感不成比例，我们的发现可能会受益于他们的焦虑和孤独。