Questionnaire to avoid transfers to healthcare: a Brazilian experience

• DOI: https://doi.org/10.1108/IJPH-04-2017-0018
• Published date: 11 June 2018
• Pages: 142-150
• Date: 11 June 2018
• Author: Carlos Willie Alvarenga,Luiz Henrique Fernandes,Antonio Pazin-Filho,Luciane Loures dos Santos
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Questionnaire to avoid transfers to

healthcare: a Brazilian experience

Carlos Willie Alvarenga, Luiz Henrique Fernandes, Antonio Pazin-Filho and

Luciane Loures dos Santos

Abstract

Purpose –The purpose of this paper is to test whether training correctional facility (CF ) officers in the

admission process would identify risk factors for inmates’unscheduled transfers to healthcare units in the first

24 hours.

Design/methodology/approach –Correctional officers (COs) were trained to use a questionnaire with ten

closed questions, which seeks to identify occupational or nosocomial risk, applied upon the admission of

inmates to a CF.

Findings –There were 1,288 admissions in six CFs in Ribeirão Preto and Serra Azul/Brazil from March 2010

to May 2011. Of those admissions, 21.2 percent were in penitentiaries and 78.9 percent in provisional

detention centers. Of the questionnaires applied, 580 answered affirmatively (45 percent) for one or more of

the questions, with nearly 60 percent related to drug use in the last 12 hours, 37.7 percent use of medications

while the most frequently mentioned diseases were respiratory diseases (37 percent) and mental disorders

(19 percent).The number of positive responses per evaluation presented an odds ratio of 3.6 (CI 95% –1.6,

10.5) for unscheduled transfers for external clinical evaluation.

Research limitations/implications –The lack of a control group and the fact that morbidities described by

prisoners could not be confirmed are study limitations. The research does, however, still contribute to the

goal of achieving appropriate medical care within CFs.

Originality/value –The training of COs to identify risk factors that predict the need for unplanned transfers to

healthcare units was feasible. These findings have important implications for CFs that do not provide ongoing

medical service, a universal reality in Brazil.

Keywords Healthcare, Brazil, Prison, In-service training, Access to health services,

Management of patient care

Paper type Research paper

Introduction

Currently, there are over 10.3 million imprisoned persons in the world. The USA is at the top of

the ranking list in terms of absolute numbers incarcerated, followed by China, Russia and Brazil

(Walmsley, 2016). While numbers in Brazil have grown slowly, there has been an increase in the

number of people detained of about 7 percent a year, resulting in a total of 879,637 currently

being held in closed, semi-open and private (at home) regimes (National Justice Council Brazil,

2016a, b). In the 2000s, there were 133 prisoners per 100,000 inhabitants, and today there are

301, far higher than the world rate of 144/100,000 (Walmsley, 2016). The state of São Paulo is

responsible for the incarceration of more than 25 percent of the Brazilian prison population.

About nine people are arrested each day in this state, worsening overcrowding in correctional

facilities (CFs) (National Justice Council Brazil, 2016b).

There are 2,775 CFs established in the 27 states that make up the Brazilian territory. These units

can accommodate 388,732 people, but currently house 636,419 inmates, causing

overcrowding and a shortage of 247,687 vacancies (63.7 percent). In the state of São Paulo,

this reality is not very different from the rest of the country, as there is currently a deficit of

94,392-70.3 percent (National Justice Council Brazil, 2016a, b).

Received 10 April 2017

Revised 1 June 2017

24 July 2017

14 August 2017

Accepted 22 August 2017

Carlos Willie Alvarenga,

Luiz Henrique Fernandes and

Antonio Pazin-Filhoa are all

based at the Department of

Internal Medicine, Ribeirão

Preto Medical School,

University of São Paulo,

Ribeirão Preto, Brazil.

Luciane Loures dos Santos is a

Professor at the Department of

Social Medicine, Ribeirão Preto

Medical School,

University of São Paulo,

Ribeirão Preto, Brazil.

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VOL. 14 NO. 2 2018, pp. 142-150, © Emerald Publishing Limited, ISSN 1744-9200 DOI 10.1108/IJPH-04-2017-0018