Examining the impact of service-user demographics and needs on engagement with community healthcare services - statistical analysis of the national RECONNECT dataset of people leaving prison

Background Individuals transitioning from custody to the community experience many challenges, which contribute to the high rates of reoffending observed globally. Fortunately, services/programmes have been developed to support individuals during the transition process, particularly around accessing health and other support services upon release from custody (e.g., the RECONNECT service in England). There are, however, important gaps in the literature, including very limited research on services/programmes outside the US and no published research examining how outcomes vary as a function of service-user characteristics. The current study fills these important gaps, focusing on the RECONNECT service in England, on which no published research exists. Results Through analysis of a national dataset comprising 13,671 RECONNECT service-users, this study provides the first descriptive profile of the demographic characteristics and recorded needs of service-users engaged with the RECONNECT service. Inferential statistical analysis examined whether RECONNECT service-user demographics and service-user needs were associated with engagement and outcomes; the first published examination of this topic. While there was variation in findings depending on how outcomes were defined, four consistent findings emerged: female service-users, White service-users, service-users aged 60 years and older, and service-users referred from community settings tended to have more positive engagement outcomes with community health and support services. Conclusions The findings from this study demonstrate that predisposing factors, such as age, gender and ethnicity, impact on engagement with health and support services amongst individuals transitioning from custody to the community, which supports theoretical frameworks developed to explain the utilisation of healthcare services (e.g., the Behavioral Model of Health Services Use). Furthermore, the findings are consistent with the large body of empirical literature that demonstrates inequities in access to and utilisation of community health and support services amongst certain demographics, particularly male service-users, non-White service-users, service-users with a disability, and service-users with substance misuse needs.