• Jesse T Young, Diane Arnold-Reed, David Preen, Max Bulsara, Nick Lennox, and Stuart A Kinner.
• Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Western Australia, Australia Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.
• BMJ Open. 2015 Jun 11; 5 (6): e008021.

ObjectiveTo describe the association between ex-prisoner primary care physician contact within 1 month of prison release and health service utilisation in the 6 months following release.DesignA cohort from the Passports study with a mean follow-up of 219 (± 44) days postrelease. Associations were assessed using a multivariate Andersen-Gill model, controlling for a range of other factors.SettingFace-to-face, baseline interviews were conducted in a sample of prisoners within 6 weeks of expected release from seven prisons in Queensland, Australia, from 2008 to 2010, with telephone follow-up interviews 1, 3 and 6 months postrelease.ParticipantsFrom an original population-based sample of 1325 sentenced adult (≥ 18 years) prisoners, 478 participants were excluded due to not being released from prison during follow-up (n=7, 0.5%), loss to follow-up (n=257, 19.4%), or lacking exposure data (n=214, 16.2%). A total of 847 (63.9%) participants were included in the analyses.ExposurePrimary care physician contact within 1 month of follow-up as a dichotomous measure.Main Outcome MeasuresAdjusted time-to-event hazard rates for hospital, mental health, alcohol and other drug and subsequent primary care physician service utilisations assessed as multiple failure time-interval data.ResultsPrimary care physician contact prevalence within 1 month of follow-up was 46.5%. One-month primary care physician contact was positively associated with hospital (adjusted HR (AHR)=2.07; 95% CI 1.39 to 3.09), mental health (AHR=1.65; 95% CI 1.24 to 2.19), alcohol and other drug (AHR=1.48; 95% CI 1.15 to 1.90) and subsequent primary care physician service utilisation (AHR=1.47; 95% CI 1.26 to 1.72) over 6 months of follow-up.ConclusionsEngagement with primary care physician services soon after prison release increases health service utilisation during the critical community transition period for ex-prisoners.Trial Registration NumberAustralian New Zealand Clinical Trials Registry (ACTRN12608000232336).Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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