Health problems among detainees in Switzerland: a study using the ICPC-2 classification

In this retrospective cross-sectional study we reviewed the health records of all detainees leaving Switzerland's largest remand prison in 2007. The health problems were coded using the International Classification for Primary Care (ICPC-2). Analyses were descriptive, stratified by gender.A total of 2195 health records were reviewed. Mean age was 29.5 years (SD 9.5); 95% were male; 87.8% were migrants. Mean length of stay was 80 days (SD 160). Illicit drug use (40.2%) and mental health problems (32.6%) were frequent, but most of these detainees (57.6%) had more generic primary care problems, such as skin (27.0%), infectious diseases (23.5%), musculoskeletal (19.2%), injury related (18.3%), digestive (15.0%) or respiratory problems (14.0%). Furthermore, 7.9% reported exposure to violence during arrest by the police.Morbidity is high in this young, predominantly male population of detainees, in particular in relation to substance abuse. Other health problems more commonly seen in general practice are also frequent. These findings support the further development of coordinated primary care and mental health services within detention centers.Prisoners are an underserved and vulnerable population. They frequently have had limited previous access to healthcare due to educational, social and economic disadvantage [1,2]. Prison has been identified as a significant opportunity to address the health needs of vulnerable groups. In particular, prison health services aim to reduce inequalities by providing primary care services that are similar in range and quality to those available in the community [3]. Addiction, psychiatric problems and infectious disease are recognized as important health problems in prison, their extent varies widely from one setting to another [1]. Belgian prisoners have been shown to make substantial use of primary care services during incarceration [4]. In US jails 36.9% of inmates in 2002 reported having a current medical problem but only 42% of them s