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Prison health care: is contracting out healthy?

Author

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  • Kelly Bedard

    (Department of Economics, University of California, Santa Barbara, CA, USA)

  • H. E. Frech

    (Department of Economics, UCSB, Santa Barbara, CA, USA)

Abstract

US prison health care has recently been in the news and in the courts. A particular issue is whether prisons should contract out for health care. Contracting out has been growing over the past few decades. The stated motivation for this change ranges from a desire to improve the prison healthcare system, sometimes in response to a court mandate, to a desire to reduce costs. This study is a first attempt to quantify the impact of this change on inmate health. As morbidity measures are not readily obtainable, we focus on mortality. More specifically, we use a panel of state prisons from 1979 to 1990 and a fixed effects Poisson model to estimate the change in mortality associated with increase in the percentage of medical personnel employed under contract. In contrast to the first stated aim of contracting, we find that a 13% increase in percentage of medical personnel employed under contract increases mortality by 1.3%. Copyright © 2009 John Wiley & Sons, Ltd.

Suggested Citation

  • Kelly Bedard & H. E. Frech, 2009. "Prison health care: is contracting out healthy?," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1248-1260.
  • Handle: RePEc:wly:hlthec:v:18:y:2009:i:11:p:1248-1260
    DOI: 10.1002/hec.1427
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    References listed on IDEAS

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    1. repec:hrv:faseco:33077889 is not listed on IDEAS
    2. Frech, H E, III, 1976. "The Property Rights Theory of the Firm: Empirical Results from a Natural Experiment," Journal of Political Economy, University of Chicago Press, vol. 84(1), pages 143-152, February.
    3. Ehrlich, Isaac & Georges Gallais-Hamonno & Zhiqiang Liu & Randall Lutter, 1994. "Productivity Growth and Firm Ownership: An Analytical and Empirical Investigation," Journal of Political Economy, University of Chicago Press, vol. 102(5), pages 1006-1038, October.
    4. Lawrence Katz & Steven D. Levitt & Ellen Shustorovich, 2003. "Prison Conditions, Capital Punishment, and Deterrence," American Law and Economics Review, Oxford University Press, vol. 5(2), pages 318-343, August.
    5. Boardman, Anthony E & Vining, Aidan R, 1989. "Ownership and Performance in Competitive Environments: A Comparison of the Performance of Private, Mixed, and State-Owned Enterprises," Journal of Law and Economics, University of Chicago Press, vol. 32(1), pages 1-33, April.
    6. Andrei Shleifer, 1998. "State versus Private Ownership," Journal of Economic Perspectives, American Economic Association, vol. 12(4), pages 133-150, Fall.
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    Cited by:

    1. McClellan, Chandler & Tekin, Erdal, 2012. "Stand Your Ground Laws and Homicides," IZA Discussion Papers 6705, Institute for the Study of Labor (IZA).
    2. Andersson, Fredrik & Jordahl, Henrik, 2011. "Outsourcing Public Services: Ownership, Competition, Quality and Contracting," Working Paper Series 874, Research Institute of Industrial Economics.
    3. Aidan R. VINING & Anthony E. BOARDMAN & Mark A. MOORE, 2014. "The Theory And Evidence Pertaining To Local Government Mixed Enterprises," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 85(1), pages 53-86, March.
    4. Chandler McClellan & Erdal Tekin, 2017. "Stand Your Ground Laws, Homicides, and Injuries," Journal of Human Resources, University of Wisconsin Press, vol. 52(3), pages 621-653.
    5. Bergman, Mats A. & Johansson, Per & Lundberg, Sofia & Spagnolo, Giancarlo, 2016. "Privatization and quality: Evidence from elderly care in Sweden," Journal of Health Economics, Elsevier, vol. 49(C), pages 109-119.

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