The Hidden Health Care Crisis Behind Bars: A Randomized Trial to Accredit U.S. Jails Marcella Alsan & Crystal Yang

https://www.nber.org/papers/w33357?utm_campaign=morning_rounds&utm_medium=email&_hsenc=p2ANqtz-_SpuuxwJy1NDF5nnaeoJOpcm7fCLn4ZTn36-W6TrJUz_U2gJzdiwmCe4-oMKMcby08o5GnWLmnExl_1x-S7QAOcRKQKw&_hsmi=342354081&utm_content=342354081&utm_source=hs_email Accreditation could drastically improve prison health care, per study Practically everybody in the U.S. receives health care from accredited institutions, as it’s how facilities get Medicare and Medicaid reimbursement. (A nonprofit called the Joint Commission affirms health care quality and safety.) There’s no similar financial incentive when it comes to health care provided in prison or jail, so just 17% of correctional facilities in the U.S. have sought a voluntary accreditation (from yet another organization, the National Commission on Correctional Health Care). But it makes a difference — accreditation reduces mortality among incarcerated people and improves quality standards, according to a new randomized controlled trial. The study is currently published as a working paper from the National Bureau of Economic Research, meaning that it hasn’t yet been peer-reviewed. Researchers followed 44 small to midsize jails across the country as half pursued accreditation (with a discount thanks to the study). They found that completing the accreditation process reduced the average deaths per month by up to 93% in the six months after the expected time of an on-site visit by the accreditor. Part of why mortality was reduced so much might be that there’s simply a great deal of room for improvement, the authors wrote. The process had no effect on the way prison staff perceive people who are incarcerated or the financial investments that institutions make toward health care. Still, it’s the first RCT across jails as well as the first focused on health care accreditation.