The determinants of individual health care expenditures in prison: evidence from Switzerland.

TitreThe determinants of individual health care expenditures in prison: evidence from Switzerland.
Publication TypeJournal Article
Year of Publication2018
AuthorsMoschetti, K, Zabrodina, V, Wangmo, T, Holly, A, Wasserfallen, J-B, Elger, BS, Gravier, B
JournalBMC health services research
Date Published03/2018
Mots-clésChronic diseases, Health care expenditures, Outpatient care, Prison

BACKGROUND: Prison health systems are subject to increasing pressures given the specific health needs of a growing and aging prison population. Identifying the drivers of medical spending among incarcerated individuals is therefore key for health care governance in prisons. This study assesses the determinants of individual health care expenditures within the prisons of the canton of Vaud, a large region of Switzerland.

METHODS: We use a unique dataset linking demographic and prison stay characteristics as well as objective measures of morbidity to detailed medical invoice data. We adopt a multivariate regression approach to model total, somatic and psychiatric outpatient health care expenditures.

RESULTS: We find that chronic infectious, musculoskeletal and skin diseases are strong predictors of total and somatic costs. Schizophrenia, neurotic and personality disorders as well as the abuse of illicit drugs and pharmaceuticals drive total and psychiatric costs. Furthermore, cumulating psychiatric and somatic comorbidities has an incremental effect on costs.

CONCLUSION: By identifying the characteristics associated with health care expenditures in prison, this study constitutes a key step towards a more efficient use of medical resources in prison.

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Alternate JournalBMC Health Serv Res
Citation Key / SERVAL ID8660
Peer reviewRefereed
PubMed ID29514629
PubMed Central IDPMC5842659
Grant ListSNF (CR13I1_135035/1) / / Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung / International


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