Prison health care: is contracting out healthy?
Article first published online: 13 JAN 2009
Copyright © 2009 John Wiley & Sons, Ltd.
Volume 18, Issue 11, pages 1248–1260, November 2009
How to Cite
Bedard, K. and Frech, H. E. (2009), Prison health care: is contracting out healthy?. Health Econ., 18: 1248–1260. doi: 10.1002/hec.1427
- Issue published online: 9 OCT 2009
- Article first published online: 13 JAN 2009
- Manuscript Accepted: 16 SEP 2008
- Manuscript Revised: 15 JUL 2008
- Manuscript Received: 17 SEP 2007
- prison health care;
- managed care;
US prison health care has recently been in the news and in the courts. A particular issue is whether prisons should contract out for health care. Contracting out has been growing over the past few decades. The stated motivation for this change ranges from a desire to improve the prison healthcare system, sometimes in response to a court mandate, to a desire to reduce costs. This study is a first attempt to quantify the impact of this change on inmate health. As morbidity measures are not readily obtainable, we focus on mortality. More specifically, we use a panel of state prisons from 1979 to 1990 and a fixed effects Poisson model to estimate the change in mortality associated with increase in the percentage of medical personnel employed under contract. In contrast to the first stated aim of contracting, we find that a 13% increase in percentage of medical personnel employed under contract increases mortality by 1.3%. Copyright © 2009 John Wiley & Sons, Ltd.