Police perspectives on the economic considerations of providing healthcare in short-term custodial settings in Australia

Author:

Brandenburg Caitlin12ORCID,Crilly Julia123,Thomas Stuart4,Gardiner Paul5,Kinner Stuart A6789,Heffernan Ed101112,Lincoln Cathy13,Somerville Annabel14,Davidson Peter15,Wilson Daniel16,Green David1,Byrnes Joshua17

Affiliation:

1. Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia

2. Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia

3. School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia

4. Social and Global Studies Centre, RMIT University, Melbourne, Victoria, Australia

5. Cairns Watch-house, Far North District, Queensland Police Service, Cairns, Queensland, Australia

6. Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia

7. Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia

8. School of Population Health, Curtin University, Perth, Western Australia, Australia

9. Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia

10. Forensic Mental Health Group, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia

11. Faculty of Medicine, The University of Queensland, Brisbane, Australia

12. Queensland Forensic Mental Health Service, Queensland Health, Brisbane, Queensland, Australia

13. Forensic Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia

14. Department of Emergency Medicine, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia

15. Department of Medicine, Division Global Public Health, University of California, San Diego, CA, USA

16. Office of the Medical Director, Queensland Ambulance Service, Kedron, Queensland, Australia

17. Centre for Applied Health Economics, School of Medicine, Griffith University, Brisbane, Queensland, Australia

Abstract

Providing appropriate healthcare to people in short-term police custody settings (i.e. watch-houses) is challenging due to the complexity of detainee health needs and the limitations of the custodial environment. However, little is known about how detainee healthcare is managed in Australia, including economic considerations. This study had two aims: (1) to understand police perspectives on the costs associated with the delivery of healthcare to watch-house detainees in Queensland, Australia and (2) to scope the applicability of the Prison Healthcare Expenditure Reporting Checklist (PHERC) tool for the Australian watch-house context. The study employed an exploratory qualitative descriptive approach. A purposive sample comprised 16 watch-house staff from six regions in Queensland, Australia, interviewed between April and November 2021. A key finding was that police viewed healthcare expenditure as a major, but largely unavoidable cost for Australian watch-houses. Participants reported that direct expenditure comprised mostly of in-house healthcare services (of which there were a variety of models), but also costs of medication and health-related consumables. Indirect costs included costs of escorting and guarding detainees requiring transfer to hospital for health assessment and treatment. Participants reported that the PHERC was not applicable to the Australian watch-house context. Future research should explore the cost-effectiveness of different watch-house healthcare delivery models and how best to measure this.

Funder

Emergency Medicine Foundation

Publisher

SAGE Publications

Subject

Law,Health Policy,Issues, ethics and legal aspects

Reference30 articles.

1. Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis

2. Prison health care: a review of the literature

3. WHO. Health in prisons, https://www.euro.who.int/__data/assets/pdf_file/0004/463288/WHO-Health-in-Prisons-eng.pdf (2020, accessed 5 January 2023).

4. Structures, processes and outcomes of health care for people detained in short-term police custody settings: A scoping review

5. Queensland Police Service (QPS). Operational Procedures Manual: Chapter 16- Custody, https://www.police.qld.gov.au/qps-corporate-documents/operational-policies/operational-procedures-manual (2022, accessed 5 January 2023).

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