Methods and tools used to assess patient experience with healthcare services in prisons: a scoping review.

BACKGROUND

Measures of patient experience of healthcare services are important to improving quality of care and health outcomes. In correctional facilities, healthcare is shaped by key features of the environment, including security constraints and uncertain lengths of stay. In this scoping review, we aimed to map the existing literature and identify knowledge gaps to inform efforts to implement and enhance measures of patient experience in correctional settings.

METHODS

We conducted a search of health sciences databases and grey literature for original research articles on 6 December 2024. We included studies in which people currently incarcerated in a correctional facility were asked about their experiences of healthcare received in custody. Two people independently assessed all titles and abstracts, reviewed full texts, and completed data extraction. We assessed how measures of patient experience in each study aligned with the Picker Principles of Patient-Centred Care.

RESULTS

Our search identified 710 unique records, and we included 44 articles reporting on 42 studies in this review. Among included studies, 21 (52%) assessed patient experience using surveys, 18 (43%) used qualitative methods, and 3 (5%) used a combination. No studies reported using a survey that had been previously validated for healthcare delivered in a correctional facility. Questions about communication with healthcare staff and access to services were more common than inquiry into perceptions of respect, empathy, and autonomy. No study asked about the involvement of family and friends in care. We found gaps in the geographic representation of studies and in reporting considerations of confidentiality and compensation for participants.

CONCLUSIONS

There is a need for validated, context-specific tools to measure patient experiences of healthcare in custody, with attention to autonomy, respect, and relational aspects of care. Addressing current gaps will support person-centred, equitable healthcare in correctional settings and support quality improvement and accountability.