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

Moschetti, Karine and Zabrodina, Véra and Wangmo, Tenzin and Holly, Alberto and Wasserfallen, Jean-Blaise and Elger, Bernice S. and Gravier, Bruno. (2018) The determinants of individual health care expenditures in prison: evidence from Switzerland. BMC health services research, 18 (160). pp. 1-13.

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Official URL: https://edoc.unibas.ch/67097/

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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.
Faculties and Departments:08 Cross-disciplinary Subjects > Ethik > Institut für Bio- und Medizinethik > Bio- und Medizinethik (Elger)
03 Faculty of Medicine > Departement Public Health > Ethik in der Medizin > Bio- und Medizinethik (Elger)
UniBasel Contributors:Wangmo, Tenzin and Zabrodina, Véra and Elger, Bernice Simone
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:BioMed Central
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:10 Dec 2018 14:19
Deposited On:10 Dec 2018 14:19

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