State and Local Correctional Health Care

Effectively administering health care programs is a critical element of sound fiscal management for state and local governments. As health care and corrections have emerged in recent years as fiscal pressure points, so, too, has the intersection of these two spheres—health care for inmates. The manner in which states and localities manage prison and jail health care services affects taxpayers’ total corrections bill, as well as inmates’ well-being and the public’s health and safety. Pew conducts research on state and local correctional health care spending and performance to help policymakers access the information they need to make data-driven policy decisions.

Inmates, when compared with the general population, have more extensive health needs, including chronic and infectious diseases, substance use disorders, and mental illnesses. States and localities make significant investments in care for these individuals. Policymakers need good information to assess their correctional systems’ performance and to ensure that they are achieving the desired health outcomes at sustainable costs. Preserving these investments also requires coordinating the care of inmates as they transition between correctional facilities and their communities.

Pew’s research examines correctional health care spending and performance through comprehensive 50-state assessments and other analyses. We seek to help states and localities better understand how they can maintain high-performing systems by effectively tracking and monitoring costs, measuring and improving the quality of care delivered, and facilitating well-coordinated health care transitions for inmates as they enter and depart the correctional system.

Prison health report
Prison health report
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State Prisons and the Delivery of Hospital Care

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State Prisons and the Delivery of Hospital Care

Delivering adequate medical care to the more than 1 million adults in state prisons is a growing challenge for states, in part because of the high costs and complex logistics required to hospitalize people who are incarcerated.

Examination table
Examination table
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Jails: Inadvertent Health Care Providers

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Jails: Inadvertent Health Care Providers

Every year, millions of people are booked into U.S. jails. During 2015, the latest year for which data are available, there were 10.9 million admissions to these correctional facilities, which hold individuals who are awaiting trial or serving short sentences. The government running the jail—usually a county—has a constitutional mandate to provide people booked into these facilities with necessary health care. Counties designing a jail health care program targeted to meet the needs of their incarcerated population have the opportunity to improve the health of people in jail and the broader community, spend public dollars more effectively, and, in some cases, reduce recidivism.

Pharmaceuticals
Pharmaceuticals
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Pharmaceuticals in State Prisons

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Adults who are incarcerated have a higher-than-average prevalence of infectious diseases, hypertension, asthma, arthritis, mental illness, and substance use disorders, often in combination. Since departments of corrections (DOCs) are legally obligated to treat individuals in their custody, they—like all health care purchasers in this country—face the challenge of pharmaceutical prices that seem to rise constantly, and sometimes rapidly.

Prison health care
Prison health care
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Prison Health Care Costs and Quality

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Prison health care sits at the intersection of pressing state priorities. From protecting public safety to fighting disease and promoting physical and behavioral health, and from fine-tuning budgets that trim waste to investing in cost-effective programming with long-term payoffs, the health care that prisons provide to incarcerated individuals and the care that prisons facilitate post-release is a critical linchpin with far-reaching implications.

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