Date of Award


Document Type


Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Annie N. Simpson

Second Advisor

Richard E. Hicks

Third Advisor

Trudie F. Milner

Fourth Advisor

James S Zoller


Objective: This study used data from the Healthcare Cost and Utilization Project State Inpatient Databases to identify whether inmates in Massachusetts had any differences in morbidity, mortality, cost, length of stay, and ambulatory care sensitive conditions as compared to a propensity-score matched (1:1 ratio) group of non-inmate patients. Methods: Differences were examined using t tests for continuous variables and Chisquare (χ2) tests for categorical variables. Multiple linear and logistic regression models were used to investigate relationships between the outcome variables and inmate/noninmate status, controlling for age, Charlson Comorbidity Index score, gender, primary payer, race, psychological conditions, suicide, and injuries. Results: On average inmates stayed 2.48 days longer in the hospital (10.40 vs. 7.92; p = <.0001), their bill was $1,691 more ($10,226 vs. $8,535; p = <.0001), and they had more chronic conditions (4.46 vs. 4.31; p =.0019) compared to non-inmate counterparts. Conclusion: The provision of healthcare to inmates is required by law, paid for by taxpayers, and managed differently at each correctional institution. Findings indicate care may not be adequate, requiring collaborative efforts to improve the provision and management of healthcare at correctional institutions.


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