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Voluntary Accreditation and Healthcare Quality: Evidence from a Randomized Controlled Trial in U.S. Jails

Author

Listed:
  • Marcella Alsan
  • Crystal Yang

Abstract

We study whether voluntary accreditation improves healthcare quality in U.S. jails, where publicly financed care is often delivered by private contractors and overseen by elected sheriffs with limited medical expertise. We conduct the first randomized controlled trial of healthcare accreditation in the United States, randomizing the offer of accreditation to 46 jails. Assignment improves compliance with quality standards, particularly in training and patient care, without increasing capital or labor inputs, and substantially reduces 12-month mortality. Descriptively, mortality reductions are concentrated in jails with the largest quality improvements. Evidence suggests effects operate through improved coordination, screening, and oversight.

Suggested Citation

  • Marcella Alsan & Crystal Yang, 2025. "Voluntary Accreditation and Healthcare Quality: Evidence from a Randomized Controlled Trial in U.S. Jails," NBER Working Papers 33357, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:33357
    Note: EH LE PE
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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty
    • K10 - Law and Economics - - Basic Areas of Law - - - General (Constitutional Law)
    • K14 - Law and Economics - - Basic Areas of Law - - - Criminal Law

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