Background
Methods
Data description
Merged administrative and invoice data
Outcome variables: Total, somatic and psychiatric health care costs
Explanatory variables
Statistical analysis
Modelling health care costs
Average partial effects (APEs) of chronic health conditions and comorbidities
Sample selection
Results
Sample and descriptive statistics
Proportion in % (N) | |
---|---|
Chronic somatic conditions | |
Infectious diseases | 9.2 (102) |
Skin problems | 6.4 (71) |
Musculoskeletal system | 10.7 (119) |
Digestive system | 7.3 (81) |
Circulatory system | 6.5 (72) |
Endocrine system | 3.4 (38) |
Respiratory system | 4.9 (54) |
Nervous system | 1.5 (17) |
Psychiatric conditions | |
Schizophrenia | 2.4 (26) |
Mood disorders | 2.1 (23) |
Neurotic disorders | 16.0 (177) |
Behavioural syndromes | 1.7 (19) |
Personality disorders | 12.4 (137) |
Mental retardation | 2.4 (26) |
Substance abuse | |
Alcohol | 9.8 (109) |
Illicit drugs | 17.5 (194) |
Pharmaceuticals | 5.7 (63) |
Demographic characteristics | |
Aged 18-29a | 49.7 (550) |
Aged 30–39 | 28.2 (312) |
Aged 40–49 | 15.7 (174) |
Aged 50 and older | 6.4 (71) |
Malea | 92.3 (1022) |
Female | 7.7 (85) |
Married | 20.1 (223) |
Swiss origin | 17.5 (194) |
Has health insurance | 42.6 (472) |
Prison stay characteristics | |
Stayed in Bois-Mermet prison | 37.6 (419) |
Stayed in Plaine d’Orbe prison | 14.4 (159) |
Stayed in Croisée prison | 50.5 (559) |
Stayed in La Tuilière prison | 11.6 (128) |
Other type of crimea | 69.3 (761) |
Violent crime | 2.8 (33) |
Sexual crime | 3.0 (31) |
Drug-related crime | 25.5 (282) |
Convicteda | 54.5 (603) |
Preventive detention | 45.5 (504) |
Under SCC article 59 | 1.4 (16) |
Under SCC article 64 | 0.3 (3) |
Number of stays in 2011b | 1.3 (0.6) |
Total length of stay in 2011 in daysb | 97.5 (93.9) |
Total incarceration time in daysb | 129.4 (239.3) |
Cumulated costs (CHF) | Total cost per day of incarceration (CHF) | Length of stay in 2011 (days) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total | Somatic | Psychiatric | ||||||||
Sample (N) | Mean | (SD) | Mean | (SD) | Mean | (SD) | Mean | (SD) | Mean | (SD) |
All (1107) | 2217 | (5416) | 660 | (2302) | 1557 | (4465) | 28.73 | (82.79) | 97 | (94) |
Positive costs onlya | 2483 | (5645) | 749 | (2439) | 1734 | (4679) | 31.77 | (86.51) | 104 | (93) |
Age group
| ||||||||||
Under 50 (1036) | 2225 | (5536) | 645 | (2351) | 1580 | (4580) | 27.01 | (67.48) | 98 | (94) |
Aged 50 and older (71) | 2105 | (3225) | 873 | (1388) | 1232 | (2164) | 53.80 | (200.73) | 95 | (100) |
Gender | ||||||||||
Male (1022) | 2140 | (5360) | 598 | (1891) | 1542 | (4589) | 26.78 | (77.91) | 99 | (95) |
Female (85) | 3142 | (6008) | 1402 | (5069) | 1740 | (2542) | 52.16 | (125.91) | 84 | (75) |
Chronic somatic conditions | ||||||||||
None (681) | 1317 | (3628) | 307 | (476) | 1010 | (3307) | 21.06 | (58.01) | 83 | (88) |
One or two (345) | 3496 | (7393) | 1083 | (3091) | 2413 | (6160) | 40.19 | (114.26) | 116 | (97) |
Three or more (81) | 4339 | (6342) | 1823 | (5199) | 2516 | (3579) | 44.40 | (93.22) | 139 | (105) |
Psychiatric conditions or substance abuse | ||||||||||
None (672) | 841 | (2561) | 492 | (2325) | 349 | (724) | 20.19 | (91.28) | 79 | (87) |
One or more (435) | 4343 | (7561) | 919 | (2243) | 3425 | (6650) | 41.93 | (65.54) | 126 | (98) |
At least one somatic and one psychiatric condition or substance abuse (226) | 5297 | (8651) | 1268 | (2996) | 4029 | (7494) | 43.13 | (62.08) | 139 | (100) |
Results of cost regression models
Total costs | Somatic costs | Psychiatric costs | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Poisson-log | Gamma-log | Poisson-log | Gamma-log | Poisson-log | Gamma-log | |||||||
Exp. coef. | (SE) | Exp. coef. | (SE) | Exp. coef. | (SE) | Exp. coef. | (SE) | Exp. coef. | (SE) | Exp. coef. | (SE) | |
Chronic somatic conditions | ||||||||||||
Infectious diseases | 2.749*** | (0.411) | 2.412*** | (0.441) | 6.323*** | (1.405) | 3.947*** | (0.907) | 1.848*** | (0.268) | 1.488** | (0.254) |
Skin problems | 1.493*** | (0.231) | 1.683** | (0.405) | 1.979*** | (0.430) | 1.609*** | (0.284) | 1.221 | (0.210) | 1.604* | (0.450) |
Musculoskeletal system | 1.335*** | (0.145) | 1.758*** | (0.289) | 1.232* | (0.134) | 1.680*** | (0.223) | 1.404** | (0.193) | 2.020*** | (0.407) |
Digestive system | 0.871 | (0.107) | 1.078 | (0.131) | 1.091 | (0.149) | 1.231* | (0.142) | 0.755 | (0.129) | 1.025 | (0.148) |
Circulatory system | 1.592 | (0.531) | 1.621* | (0.404) | 2.546*** | (0.904) | 1.707*** | (0.317) | 1.047 | (0.230) | 1.447 | (0.410) |
Endocrine system | 1.143 | (0.286) | 1.165 | (0.258) | 1.523 | (0.414) | 1.762*** | (0.332) | 1.072 | (0.274) | 0.973 | (0.261) |
Respiratory system | 0.890 | (0.142) | 0.810 | (0.109) | 0.902 | (0.170) | 0.835 | (0.102) | 0.963 | (0.171) | 0.799 | (0.122) |
Nervous system | 1.211 | (0.279) | 1.522* | (0.338) | 1.184 | (0.242) | 1.155 | (0.167) | 1.139 | (0.359) | 1.737** | (0.482) |
Psychiatric conditions | ||||||||||||
Schizophrenia | 2.549*** | (0.468) | 2.369*** | (0.516) | 0.967 | (0.340) | 0.748 | (0.154) | 3.090*** | (0.648) | 3.290*** | (0.802) |
Mood disorder | 1.096 | (0.197) | 0.871 | (0.156) | 1.116 | (0.309) | 1.155 | (0.246) | 1.336* | (0.230) | 0.854 | (0.187) |
Neurotic disorder | 1.674*** | (0.185) | 1.622*** | (0.173) | 1.319* | (0.201) | 1.466*** | (0.166) | 1.903*** | (0.219) | 1.776*** | (0.201) |
Behavioral syndrome | 0.911 | (0.170) | 0.949 | (0.172) | 0.613** | (0.144) | 0.587*** | (0.103) | 1.118 | (0.232) | 1.279 | (0.277) |
Personality disorder | 1.455*** | (0.190) | 1.252* | (0.145) | 1.304* | (0.177) | 1.139 | (0.136) | 1.545*** | (0.243) | 1.326** | (0.170) |
Mental retardation | 1.261 | (0.367) | 1.189 | (0.211) | 1.355 | (0.415) | 0.810 | (0.149) | 1.197 | (0.466) | 1.460* | (0.308) |
Substance abuse | ||||||||||||
Alcohol | 1.030 | (0.119) | 1.315*** | (0.139) | 0.871 | (0.098) | 0.952 | (0.091) | 1.054 | (0.162) | 1.573*** | (0.191) |
Illicit drugs | 1.288** | (0.156) | 1.878*** | (0.269) | 0.582*** | (0.109) | 1.060 | (0.130) | 1.710*** | (0.239) | 2.542*** | (0.402) |
Pharmaceuticals | 1.914*** | (0.277) | 1.735*** | (0.281) | 1.559** | (0.288) | 1.215 | (0.185) | 2.079*** | (0.347) | 2.219*** | (0.479) |
Demographic characteristics | ||||||||||||
Aged 30–39 | 1.222* | (0.141) | 1.372** | (0.173) | 1.584*** | (0.251) | 1.153 | (0.128) | 1.056 | (0.147) | 1.508*** | (0.213) |
Aged 40–49 | 1.405*** | (0.173) | 1.397** | (0.184) | 2.249*** | (0.388) | 1.521*** | (0.206) | 1.061 | (0.146) | 1.382** | (0.206) |
Aged 50 and older | 0.994 | (0.287) | 2.544*** | (0.789) | 1.377 | (0.405) | 1.811*** | (0.405) | 0.956 | (0.275) | 3.285*** | (1.241) |
Female | 0.559** | (0.154) | 0.809 | (0.345) | 1.207 | (0.425) | 1.157 | (0.391) | 0.374*** | (0.105) | 0.815 | (0.403) |
Married | 1.144 | (0.197) | 1.146 | (0.138) | 1.152 | (0.242) | 1.011 | (0.113) | 1.085 | (0.198) | 1.133 | (0.146) |
Swiss origin | 1.104 | (0.134) | 1.429** | (0.215) | 0.817 | (0.147) | 1.166 | (0.167) | 1.240 | (0.181) | 1.602*** | (0.265) |
Health insurance | 1.145 | (0.123) | 0.930 | (0.097) | 1.036 | (0.185) | 0.866 | (0.085) | 1.224 | (0.162) | 0.971 | (0.115) |
Prison stay characteristics | ||||||||||||
Stayed in Bois-Mermet prison | 0.558*** | (0.090) | 0.672** | (0.113) | 0.798 | (0.186) | 0.766* | (0.121) | 0.444*** | (0.076) | 0.620** | (0.126) |
Stayed in Plaine d’Orbe prison | 0.798 | (0.136) | 0.656** | (0.120) | 0.989 | (0.251) | 0.785 | (0.131) | 0.685** | (0.130) | 0.610** | (0.141) |
Stayed in Croisée prison | 0.840 | (0.135) | 0.783 | (0.127) | 1.086 | (0.290) | 0.910 | (0.142) | 0.687** | (0.112) | 0.701* | (0.136) |
Stayed in La Tuilière prison | 1.621** | (0.347) | 1.892*** | (0.436) | 1.619 | (0.515) | 1.428 | (0.314) | 1.344 | (0.283) | 1.764** | (0.455) |
Violent crime | 0.634* | (0.166) | 0.919 | (0.210) | 0.743 | (0.207) | 0.869 | (0.177) | 0.713 | (0.182) | 1.035 | (0.295) |
Sexual crime | 1.587** | (0.319) | 1.411* | (0.279) | 2.058** | (0.609) | 1.449 | (0.340) | 1.478* | (0.306) | 1.263 | (0.291) |
Drug-related crime | 0.890 | (0.106) | 0.725*** | (0.079) | 0.973 | (0.133) | 0.824* | (0.083) | 0.902 | (0.109) | 0.709*** | (0.090) |
Preventive detention | 1.270** | (0.152) | 1.204 | (0.151) | 1.366** | (0.203) | 1.162 | (0.131) | 1.236 | (0.166) | 1.176 | (0.161) |
Under art. 59 SCC | 3.009*** | (0.755) | 7.282*** | (3.106) | 1.372 | (0.677) | 2.580** | (1.152) | 2.952*** | (0.819) | 9.796*** | (4.406) |
Under art. 64 SCC | 1.340 | (0.419) | 4.216 | (3.727) | 0.714 | (0.265) | 0.960 | (0.630) | 1.620 | (0.498) | 6.678** | (6.303) |
Number of stays in 2011 | 1.102 | (0.150) | 1.219* | (0.131) | 1.100 | (0.148) | 1.056 | (0.088) | 1.138 | (0.173) | 1.305** | (0.168) |
Total length of stay | 0.999*** | (0.000) | 0.998*** | (0.000) | 0.998*** | (0.000) | 0.998*** | (0.000) | 0.999*** | (0.000) | 0.997*** | (0.000) |
Ln(Length of stay in 2011) | 1 (exposure) | 1 (exposure) | 1 (exposure) | 1 (exposure) | 1 (exposure) | 1 (exposure) | ||||||
Constant | 11.427*** | (1.883) | 12.347*** | (1.982) | 2.522*** | (0.658) | 5.519*** | (0.879) | 9.225*** | (1.636) | 6.970*** | (1.268) |
Modified Park testa | 1.032 | 1.459*** | 1.337*** | 1.724* | 0.866 | 1.458*** | ||||||
Hosmer-Lemeshow test (p-value) | 0.068* | 0.000*** | 0.000*** | 0.000*** | 0.091* | 0.000*** | ||||||
Cross-sample RMSE | 4788.92 | 16,395.76 | 2305.08 | 2245.27 | 4474.69 | 24,926.08 | ||||||
Cross-sample MPE | −82.91 | − 1600.29 | −16.97 | −102.17 | −116.94 | − 2336.04 |
Chronic somatic conditions
Mental health conditions and substance abuse problems
Demographic characteristics
Prison stay characteristics
Average partial effects
Poisson-log GLM | Gamma-log GLM | |||
---|---|---|---|---|
APE | (SE) | APE | (SE) | |
Chronic somatic conditions | ||||
Infectious diseases | 3226*** | (710) | 4540*** | (1448) |
Skin problems | 1054** | (479) | 2390* | (1434) |
Musculoskeletal system | 711** | (292) | 2496*** | (966) |
Digestive system | −291 | (247) | 280 | (467) |
Circulatory system | 1272 | (1125) | 2089 | (1364) |
Endocrine system | 315 | (624) | 582 | (897) |
Respiratory system | −245 | (320) | − 695* | (419) |
Nervous system | 465 | (609) | 1865 | (1217) |
Psychiatric conditions | ||||
Schizophrenia | 3138*** | (878) | 4422*** | (1548) |
Mood disorder | 210 | (427) | − 469 | (598) |
Neurotic disorder | 1308*** | (318) | 1920*** | (501) |
Behavioural syndrome | −197 | (381) | − 183 | (623) |
Personality disorder | 907*** | (340) | 836* | (440) |
Mental retardation | 569 | (797) | 670 | (752.) |
Substance abuse | ||||
Alcohol | 65 | (260) | 1076** | (480) |
Illicit drugs | 578** | (282) | 2495*** | (784) |
Pharmaceuticals | 1877*** | (554) | 2507** | (1009) |
Infectious diseases | Skin problems | Musculoskeletal diseases | Circulatory diseases | |||||
---|---|---|---|---|---|---|---|---|
APE | (SE) | APE | (SE) | APE | (SE) | APE | (SE) | |
Psychiatric conditions | ||||||||
Schizophrenia | 4576*** | (1681) | 1487* | (883) | 1005* | (536) | 1795 | (1452) |
Mood disorder | 306 | (613) | 100 | (211) | 67 | (136) | 121 | (236) |
Neurotic disorder | 1893*** | (607) | 621** | (316) | 419** | (210) | 753 | (623) |
Behavioral syndrome | −287 | (552) | −94 | (180) | −63 | (126) | −113 | (247) |
Personality disorder | 1318** | (586) | 431 | (286) | 291* | (164) | 521 | (449) |
Mental retardation | 827 | (1166) | 271 | (383) | 183 | (254) | 327 | (541) |
Substance abuse | ||||||||
Alcohol | 95 | (379) | 31 | (126) | 21 | (83) | 37 | (149) |
Illicit drugs | 853** | (372) | 275 | (180) | 185* | (109) | 331 | (303) |
Pharmaceuticals | 2750** | (1017) | 894** | (427) | 602** | (305) | 1075 | (1058) |