This study examines differences in episodic health care utilization related to copayment fees in prison. Copayments in correctional institutions may affect men and women differently, as there are gender-specific health needs, differences in the frequencies men and women require medical services, and gendered differences in the financial resources at people's disposal inside the prison environment. Survey data and interviews from 140 males and females incarcerated across two prisons revealed copayments were a significant barrier for those seeking medical attention and reduced utilization. Results from content analysis and zero-inflated Poisson regression models demonstrated the copayments were a greater barrier to treatment for women compared to men, even when considering one's financial resources. Race and self-reported physical health were also significantly associated with avoiding care due to copayments.
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References
1.
AmmarN. H., & ErezE. (2000). Health delivery systems in women's prisons: The case of Ohio. Federal Probation, 64(1), 19–26.
BinswangerI. A., RedmondN., SteinerJ. F., & HicksL. S. (2012). Health disparities and the criminal justice system: An agenda for further research and action. Journal of Urban Health, 89(1),98–107. https://doi.org/10.1007/s11524-011-9614-1
BoulwareL. E., CooperL. A., RatnerL. E., LaVeistT. A., & PoweN. R. (2003). Race and trust in the health care system. Public Health Reports. 118(4),358–365. https://doi.org/10.1093/phr/118.4.358
6.
BrentJ. J., & KraskaP. B. (2010). Moving beyond our methodological default: A case for mixed methods. Journal of Criminal Justice Education, 21(4),412–430. https://doi.org/10.1080/10511253.2010.516562
7.
BrookR. H., WareJ. E., RogersW. H., et al. (1984). The effect of coinsurance on the health of adults: Results from the RAND health insurance experiment (Report R-3055-HHS). RAND Corporation. https://www.rand.org/pubs/reports/R3055.html
CourtenayW. H. (2000). Engendering health: A social constructionist examination of men's health beliefs and behaviors. Psychology of Men & Masculinity, 1(1),4–15. https://doi.org/10.1037/1524-9220.1.1.4
10.
CovingtonS. S., & BloomB. E. (2007). Gender responsive treatment and services in correctional settings. Women & Therapy, 29(3–4),9–33. https://doi.org/10.1300/j015v29n03_02
11.
CreswellJ. W., ShopeR., Plano ClarkV. L. P., & GreenD. O. (2006). How interpretive qualitative research extends mixed methods research. Research in the Schools, 13(1),1–11.
12.
DelgadoM. & Humm-DelgadoD. (2009). Health and health care in the nation's prisons: Issues, challenges, and policies. Rowman & Littlefield Publishers.
13.
FearnN. E., & ParkerK. (2005). Health care for women inmates: Issues, perceptions and policy considerations. Californian Journal of Health Promotion, 3(2),1–22. https://doi.org/10.32398/cjhp.v3i2.1760
14.
FisherA. A. & HattonD. C. (2010). A study of women prisoners' use of co-payments for health care: Issues of access. Women's Health Issues, 20(3),185–192. https://doi.org/10.1016/j.whi.2010.01.005
15.
FreudenbergN. (2001). Jails, prisons, and the health of urban populations: A review of the impact of the correctional system on community health. Journal of Urban Health, 78(2),214–235. https://doi.org/10.1093/jurban/78.2.214
16.
GaldasP. M., CheaterF., & MarshallP. (2005). Men and health help-seeking behaviour: Literature review. Journal of Advanced Nursing, 49(6),616–623. https://doi.org/10.1111/j.1365-2648.2004.03331.x
17.
GipsonF. T., & PierceE. A. (1996). Current trends in state inmate user fee programs for health services. Journal of Correctional Health Care, 3(2),159–178. https://doi.org/10.1177/107834589600300205
GoldkuhleU. (1999). Health service utilization by women in prison: Health needs indicators and response effects. Journal of Correctional Health Care, 6(1),63–83. https://doi.org/10.1177/107834589900600105
20.
HattonD. C., KleffelD., & FisherA. A. (2006). Prisoners' perspectives of health problems and healthcare in a US women's jail. Women Health, 44(1),119–136. https://doi.org/10.1300/j013v44n01_07
21.
HsiehH. F., & ShannonS. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9),1277–1288. https://doi.org/10.1177/1049732305276687
22.
HydeR. & BrumfieldB. (2003). Effect of co-payment on the use of medical services by male and female prisoners. Journal of Correctional Health Care, 9(4),371–380. https://doi.org/10.1177/107834580300900402
23.
Ingram-FogelC. (1991). Health problems and needs of incarcerated women. Journal of Prison & Jail Health, 10(1),43–57.
KiilA., & HoulbergK. (2014). How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011. European Journal of Health Economics, 15(8),813–828. https://doi.org/10.1007/s10198-013-0526-8
LindquistC. H., & LindquistC. A. (1999). Health behind bars: Utilization and evaluation of medical care among jail inmates. Journal of Community Health, 24(4),285–303. https://doi.org/10.1023/a:1018794305843
28.
LongJ. S., & FreeseJ. (2006). Regression models for categorical dependent variables using Stata (2nd ed.). Stata Press.
NoviskyM. A. (2018). Avoiding the runaround: The link between cultural health capital and health management among older prisoners. Criminology, 56(4),643–678. https://doi.org/10.1111/1745-9125.12188
33.
NowotnyK. M. (2016). Social factors related to the utilization of health care among prison inmates. Journal of Correctional Health Care, 22(2),129–138. https://doi.org/10.1177/1078345816633701
34.
O'BrienR., HuntK., & HartG. (2005). ‘It's caveman stuff, but that is to a certain extent how guys still operate’: Men's accounts of masculinity and help seeking. Social Science & Medicine, 61(3),503–516. https://doi.org/10.1016/j.socscimed.2004.12.008
35.
OsgoodD. W. (2000). Poisson-based regression analysis of aggregate crime rates. Journal of Quantitative Criminology, 16(1),21–43. https://doi.org/10.1023/A:1007521427059
36.
OwensG. (2008). Gender differences in health care expenditures, resource utilization, and quality of care. Journal of Managed Care Pharmacy, 14(3 Supp A),2–6. https://doi.org/10.18553/jmcp.2008.14.s3-a.2
37.
PerellaA., & AmmarN. (2007). How co-payments affect access to prison health care services: The experiences of women in two Ohio prisons. Corrections Compendium, 32(2), 6–10,32–33.
38.
PotterR. H. (2010). Lessons learned from 25+ years of universal health care provision: Where is the voice of correctional health care? Journal of Correctional Health Care, 16(2), 160–161. https://doi.org/10.1177/1078345809360195
39.
RamaswamyM., & FreudenbergN. (2007). Health promotion in jails and prisons: An alternative paradigm for correctional health services. In R. B. Greifinger (Ed.), Public health behind bars: From prisons to communities (1st ed., pp. 229–248). Springer. https://doi.org/10.1007/978-0-387-71695-4_13
40.
Regitz-ZagrosekV. (2012). Sex and gender differences in health (Science & society series on sex and science). EMBO Reports, 13(7),596–603. https://doi.org/10.1038/embor.2012.87
41.
RobbinsI. P. (1999). Managed health care in prisons as cruel and unusual punishment. Journal of Criminal Law and Criminology, 90(1),195–238. https://doi.org/10.2307/1144165
42.
RoldW. J. (1996). Charging inmates for medical care: A legal, practical, and ethical critique. Journal of Correctional Health Care, 3(2),129–143. https://doi.org/10.1177/107834589600300203
VaidyaV., ParthaG., & KarmakarM. (2012). Gender differences in utilization of preventive care services in the United States. Journal of Women's Health, 21(2),140–145. https://doi.org/10.1089/jwh.2011.2876
47.
WashingtonH. A. (2006). Medical apartheid: The dark history of medical experimentation on Black Americans from colonial times to the present. Doubleday.
48.
WeilandC. (1996). Fee-for-service programs: A literature review and results of a national survey. Journal of Correctional Health Care, 3(2),145–158. https://doi.org/10.1177/107834589600300204
