NCJ Number
241663
Date Published
February 2013
Length
44 pages
Annotation
This report recommends ways to reduce inmate health care costs without sacrificing the quality of inmate health care, with attention to health practices in local jails and State and Federal prisons.
Abstract
The first group of recommendations reduces the amount of medical care needed through preventive health care and a reduction in unnecessary medical visits. The second group of recommendations pertain to practices that reduce the health-care costs per inmate treated, such as providing more health care in-house in order to reduce transpiration and guard costs for visits to community hospitals. Five approaches are recommended for reducing inmates' need for health care. First, screen inmates on intake and treat diseases and conditions. This prevents the spread of contagious diseases and reduces the severity of existing illnesses, thus reducing the treatment levels needed later. Second, conduct screening of requests for hospitalization and other health services. Third, require co-payments for medical visits. Fourth, allow inmates to directly purchase over-the-counter drugs. Fifth, provide court reminders for those arraigned but not yet jailed, so as to reduce unnecessary jail time. Five recommendations are offered for reducing health-care costs per inmate treated. First, expand the use of telemedicine (diagnosis and treatment recommendations via closed circuit television). Second, reduce the number of times when nurses dispense medications. Third, continue to identify less expensive yet effective medications for physical and mental ailments. Fourth, eliminate 24-hour services when not needed and fifth, base new health-care contracts, at least in part on inmate population size. The aforementioned recommendations were reviewed for their cost-savings potential; their impact on service quality; transferability; the impact on staff; and impact on the community (such as health and safety of citizens and effects on inmates' families). The proposed policies were identified through Internet searches and discussions with experts in the field. 37 references and appended California Health Performance Metrics Dashboard