Date of Award

Spring 2022

Degree Type

Open Access Dissertation

Degree Name

Public Health, DPH

Program

School of Community and Global Health

Advisor/Supervisor/Committee Chair

Paula H. Palmer

Dissertation or Thesis Committee Member

Bin Xie

Dissertation or Thesis Committee Member

Debbie Freund

Dissertation or Thesis Committee Member

Judi Nightingale

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Rights Information

© 2022 Nirshila Chand

Abstract

Formerly incarcerated individuals suffer from poor health outcomes and often overuse emergency department (ED) services because of a lack of access to care and insurance coverage upon reentry to their community. The Riverside County Whole Person Care (WPC) pilot program implemented by Riverside University Health System (RUHS) was designed as a reentry program developed to address these challenges and ensure that releasees successfully transition back into the community. The primary aim of this project was to assess whether participating in the RUHS WPC program reduced emergency department (ED) use among recent releasees. This was a cross-sectional retrospective study of formerly incarcerated individuals who participated in the RUHS WPC pilot program during 2017, 2018, and 2019. The study hypothesized that those who complied to their referrals and gained active Medi-Cal benefits, and encountered services for outpatient visits, substance use treatment, and mental health treatment services, and who were not homeless would reduce the likelihood of ED use among releasees during the 12-month period after initial screening for the RUHS WPC pilot program. Several logistic regression analyses were utilized, and the study showed mixed findings. For instance, having active Medi-Cal benefits and mental health treatment services were not significantly related to ED use. Homeless status and outpatient visits had greater odds of using the ED. Interestingly, substance use disorder treatment services were not significantly associated with ED use in either model but were significant when all different encounters were controlled in the model. Despite this study’s findings, the RUHS WPC program stakeholders and staff have been instrumental in supporting the health outcomes of releasees and have impacted health equity. Future studies are needed to continue to assess the relationship between reentry services and ED use among releasees.

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