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The determinants of individual health care expenditures in prison: evidence from Switzerland
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID 4488770
Author(s) Moschetti, Karine; Zabrodina, Véra; Wangmo, Tenzin; Holly, Alberto; Wasserfallen, Jean-Blaise; Elger, Bernice S.; Gravier, Bruno
Author(s) at UniBasel Wangmo, Tenzin
Zabrodina, Véra
Elger, Bernice Simone
Year 2018
Title The determinants of individual health care expenditures in prison: evidence from Switzerland
Journal BMC health services research
Volume 18
Number 160
Pages / Article-Number 1-13
Keywords Chronic diseases; Health care expenditures; Outpatient care; Prison
Abstract 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.
Publisher BioMed Central
ISSN/ISBN 1472-6963
Full Text on edoc No
Digital Object Identifier DOI 10.1186/s12913-018-2962-8
ISI-Number WOS:000426855700002
Document type (ISI) Article

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