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Systematic Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2018.00716

The Costs of Healthcare in Prison and Custody: Systematic Review of Current Estimates and Proposed Guidelines for Future Reporting

  • 1University of North Carolina at Chapel Hill, United States
  • 2Oxford Health NHS Foundation Trust, United Kingdom
  • 3University of Oxford, United Kingdom

Aims
We aimed to review prison healthcare expenditure internationally.

Objectives
To systematically review healthcare spending on prisoners worldwide, examine comparability between countries, and develop guidelines to improve reporting.

Methods
Five bibliographic indexes (International Monetary Fund, ProQuest: Statistical Abstracts of the World, PubMed, Google Scholar, and JSTOR) were searched for the costs of prison and prison healthcare, supplemented with country-specific searches for the 20 countries with the highest prison populations. Information on overall healthcare costs, their breakdown by categories, and their proportion to overall prison expenditure was extracted. PRISMA guidelines were followed.

Results
Prison healthcare expenditure data was identified for 10 countries, and overall operating costs were reported for 12 countries. The most commonly reported healthcare cost was for primary medical care. Healthcare costs reporting varied widely, and few countries were comparable. We developed a set of guidelines for consistent and transparent reporting of healthcare costs.

Conclusions
Few countries report the costs of healthcare services in prison. When reported, there is a lack of clarity and consistency as to what is included in these costs. Using the proposed reporting guidelines would enable national trends and international comparisons to be investigated, and any recommended benchmarks to be monitored.

Keywords: Prison, Costs, custody, Expenditure, Healthcare service

Received: 08 Oct 2018; Accepted: 06 Dec 2018.

Edited by:

Thomas Nilsson, Department of Forensic Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden

Reviewed by:

Peter Andiné, University of Gothenburg, Sweden
Annette Opitz-Welke, Charité Medical University of Berlin, Germany  

Copyright: © 2018 Sridhar, Cornish and Fazel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Seena Fazel, University of Oxford, Oxford, United Kingdom, seena.fazel@psych.ox.ac.uk