Diabetes and hypertension care among male prisoners in Mexico City: exploring transition of care and the equivalence principle

Abstract

Objectives

To document the performance of diabetes and hypertension care in two large male prisons in Mexico City.

Methods

We analyzed data from a cross-sectional study carried out during July–September 2010, including 496 prisoners with hypertension or diabetes in Mexico City. Bivariate and multivariable logistic regressions were used to assess process-of-care indicators and disease control status.

Results

Hypertension and diabetes prevalence were estimated on 2.1 and 1.4 %, respectively. Among prisoners with diabetes 22.7 % (n = 62) had hypertension as comorbidity. Low achievement of process-of-care indicators—follow-up visits, blood pressure and laboratory assessments—were observed during incarceration compared to the same prisoners in the year prior to incarceration. In contrast to nonimprisoned diabetes population from Mexico City and from the lowest quintile of socioeconomic status at the national level, prisoners with diabetes had the lowest performance on process-of-care indicators.

Conclusions

Continuity of care for chronic diseases, coupled with the equivalence of care principle, should provide the basis for designing chronic disease health policy for prisoners, with the goal of consistent transition of care from community to prison and vice versa.