- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01179035
Evaluation of Transitions Clinic: A Post-Release Clinic for Recently Released Parolees With Chronic Medical Conditions
The Impact of Parolee-Targeted Care Versus Expedited Usual Care on Health Care Utilization and Recidivism
The purpose of this study is to study the effectiveness of the Transitions Clinic, a post-release clinic for parolees with chronic medical conditions, in achieving increased primary care engagement, lower rates of inappropriate hospitalizations, psychiatric emergency service and emergency department use, and decreased recidivism.
We hypothesize that subjects receiving parolee-targeted care in the Transitions Clinic will have increased rates of non-emergency department ambulatory care and outpatient mental health care, lower rates of hospitalization, psychiatric emergency service (PES) utilization, emergency department (ED) utilization, decreased total hospital length of stay, and decreased recidivism compared to patients receiving primary care from other safety-net providers.
Study Overview
Status
Intervention / Treatment
Detailed Description
With ever increasing numbers of released inmates, policymakers are developing policy initiatives and directing funding towards community reentry programs for recent parolees to decrease recidivism and improve health outcomes. These reentry programs are comprehensive efforts that coordinate social and medical services for recently incarcerated people to achieve these aims. Due to documented poor health outcomes in this population and the resultant costs on the public health system, provision of medical care will be an integral part of these reentry initiatives. The manner in which medical care is incorporated into community reentry programs and directed to recently released prisoners needs to be studied to guide architects of reentry programs, policymakers and allocation of funding.
The Transitions Clinic (TC) was founded to address the medical needs of recently released prisoners. The TC is a pilot project designed to target primary care medical services to parolees in San Francisco and aid in coordination of medical and social services. It operates within the San Francisco Department of Public Health(SFDPH)-affiliated Community Health Network (CHN) and is part of the Safe Communities Reentry Council, a city-wide, collaborative effort of the Sheriff's office, Public Defenders' office and local community organizations to improve reentry services and outcomes for the 1500 annual parolees to San Francisco.
The proposed project will prospectively examine the effectiveness of the TC in achieving increased primary care engagement, decreased acute health care utilization and decreased recidivism. After intake in the TC, patients will be randomized to continued, parolee-targeted care in TC versus referral to safety net medical providers for non-targeted care. We believe that the results of the study will assist policymakers by improving our understanding of the:
- effect of targeted and non-targeted medical care provision to post-release prisoners on primary care engagement and utilization
- effect of targeted and non-targeted medical care provision to post-release prisoners on inpatient hospitalizations and emergency room and psychiatric emergency service utilization.
- effect of targeted and non-targeted care provision to post-release prisoners on recidivism
- costs for provision of targeted versus non-targeted medical care to post-release prisoners (Do we want to do a cost analysis?)
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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California
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San Francisco, California, United States, 94124
- Southeast Health Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- All adult parolees to San Francisco
- Must have one chronic condition or age >50 years old
Exclusion Criteria:
- Children
- Subjects who already have an established primary care provider in San Francisco
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Expedited Primary Care
Following randomization, subjects receive ongoing primary care in the San Francisco Department of Public Health affiliated primary care network.
Appointments are expedited with safety-net primary care providers.
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Following randomization, subjects receive ongoing primary care in the San Francisco Department of Public Health affiliated primary care network.
Appointments are expedited with safety-net primary care providers.
|
Experimental: Transitions Clinic - Parolee Targeted Care
Following randomization, subjects in this arm receive ongoing primary care in a parolee-targeted clinic.
Parolee-targeted care includes care from clinicians with a knowledge of the impacts of incarceration on health and experience caring for formerly incarcerated patients, a community health worker that works in medical and social services coordination and chronic disease education, and linkages with community-based organizations serving formerly incarcerated individuals.
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Subjects receive ongoing primary care from the Transitions Clinic versus ongoing primary care in the San Francisco Department of Public Health affiliated primary care network.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Acute Care Utilization
Time Frame: 6 months
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Hospitalization and hospital length of stay and psychiatric emergency and emergency department utilization
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6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Primary Care Engagement
Time Frame: 6 months
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Non-emergency department visits to ambulatory primary care and mental health providers
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6 months
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Recidivism
Time Frame: 6 months
|
Rate of re-incarceration during study period
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6 months
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Collaborators and Investigators
Sponsor
Collaborators
Publications and helpful links
Study record dates
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- Transitions001
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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