title: A comparison of acuity and treatment measures of inmate and noninmate hospital patients with a diagnosis of either heart disease or chest pain.
abstract: OBJECTIVE
  This paper used the Healthcare Cost and Utilization Project National Inpatient Survey for the period 1998-2004 to examine whether California male inmate hospital patients with a primary diagnosis of heart disease or chest pain receive poorer quality of care (measures = number and type of procedures and time from admission to first procedure) or are sicker (measures = length of stay, risk of mortality, severity of illness, and number of diagnoses) compared to noninmate patients.
  
  
  METHODS
  Differences between inmates and noninmates were examined using a t test for continuous variables and a chi2 test for categorical variables. Multiple linear regression, logistic regression, and ordered logistic regression were used to investigate relationships between the outcome variables and inmate/noninmate status, controlling for age, race, expected payer, hospital, and total charges.
  
  
  RESULTS
  Being an inmate was not statistically significantly associated with acuity or quality of care for patients with chest pain. For patients with heart disease, being an inmate was statistically significantly associated with a decrease in time to first procedure of 0.464 days (standard error = 0.189, p = .015) and an increase in length of stay of 0.81 days (standard error = 0.256, p = .002).
  
  
  CONCLUSIONS
  The provision of health care to prison inmates is required by law, paid for by taxpayers, and increasing as the inmate population increases. The findings that, on average, inmate patients with heart disease stay in the hospital longer and receive treatment sooner compared to noninmate patients do not indicate that inmates receive poorer quality of care compared to noninmates.
authors: University of Kentucky, Lexington, USA. sjwinter@stanford.edu
authors: Sandra Jane
authors: SJ
authors: Winter
mesh_terms: D002140:California / Q000453:epidemiology; D002637:Chest Pain / Q000453:epidemiology / Q000628:therapy*; D016009:Chi-Square Distribution; D054625:Healthcare Disparities; D006331:Heart Diseases / Q000453:epidemiology / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D011787:Quality of Health Care; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome