There were a significant number of COVID-19 outbreaks in prisons during the pandemic, and between March 2020 and April 2021, there were 3.3 times the rate of deaths of prison residents in England and Wales compared with people of the same age and sex in the general population. The aim of this study is to understand the rate of hospitalisation (admitted patient care) where an individual in prison tested positive for COVID-19 compared with the general population in 2020/2021, and how non-COVID-19 hospital admissions compared with the general population.
Journal article information
- Journal of publication: BMJ Public Health
- Nuffield Trust contributor: Dr Miranda Davies
- All authors: Miranda Davies and Anjana Roy
- Volume: 2
- Issue: 1
- Page range: https://doi.org/10.1136/bmjph-2023-000515
Abstract
Objective
To compare the rate of inpatient admissions of prison residents with COVID-19 to the general population and to consider differences in the use of inpatient and outpatient services by prison residents in England in the first year of the pandemic (2020/2021), to the 12 months prior to the pandemic (2019/2020).
Methods
The pseudonymised records of patients who accessed admitted patient care and outpatient hospital services from a prison address in England between 1 April 2019 and the 31 March 2021 were extracted from Hospital Episode Statistics data. Descriptive statistics summarise the most common primary admitting diagnosis and the proportion of outpatient appointments attended and not attended. Indirectly standardised adjusted admission rate was calculated to compare the rate of inpatient admissions by prison residents with COVID-19 to the general population.
Results
The standardised adjusted admission rate for COVID-19 was 2.2 times higher in prison than the general population. Hospital data highlight continuing challenges regarding high levels of violence and self-harm resulting in hospital admissions during a period when people were spending an increasing amount of time in their cells.
Conclusions
Despite efforts to minimise the spread of COVID-19 in secure settings, prison residents in England were significantly more likely to be hospitalised with a COVID-19 diagnosis relative to the general population during the first year of the pandemic. This is in addition to the wider implications of the COVID-19 restrictions, particularly spending extended periods in isolation, on people’s mental health.