A groundbreaking randomized trial conducted across 44 U.S. jails by Marcella Alsan, PhD, MD, of the Harvard Kennedy School, and Crystal Yang, PhD, JD, of Harvard Law School, has demonstrated that NCCHC accreditation significantly improves compliance with health care standards, reduces mortality, and lowers recidivism rates.
Key Findings
The study, which has not yet been peer reviewed, highlights the transformative impact of NCCHC accreditation on jail health care:
- Improved Compliance: Accreditation increased adherence to:
- Personnel training standards by 15%.
- Patient care and treatment standards by 11%.
- Reduced Mortality: Accredited facilities saw a 86% reduction in mortality rates, saving nearly 20 lives during the study period. This equates to 0.25 fewer deaths per month.
- Lower Recidivism: Individuals released from accredited facilities were 52% less likely to return to the same jail within six months, showcasing the lasting benefits of better health care during incarceration.
Massive Return on Investment
The study estimated that NCCHC accreditation generated $59 million in benefits, far outweighing the costs of the program. These benefits included:
- Reduced Legal Liabilities: Accreditation helps jails meet legal requirements and minimize the risk of lawsuits.
- Enhanced Operational Efficiency: Improved processes streamline health care delivery and reduce errors.
- Public Health Improvements: Lower recidivism rates and healthier individuals upon release lead to better outcomes for communities.
Deborah Ross, CCHP, CEO of NCCHC, praised the findings: “For years, we’ve had anecdotal evidence about the power of accreditation to improve quality. Now, a rigorous scientific study has shown these improvements are extremely tangible. We are very grateful to the researchers, our accreditation staff and surveyors, and the participating jails.”
How the Study Was Conducted
The trial divided the 44 participating jails into two groups:
- 22 Treatment Facilities: Received substantial subsidies to pursue accreditation.
- 22 Control Facilities: Received smaller subsidies to begin the process at the study’s end.
Researchers developed and administered comprehensive questionnaires for jail leadership, custody staff, and health care staff. They also conducted:
- Independent audits of medical records and death logs.
- Qualitative interviews with jail leadership and incarcerated individuals.
- Surveys of experts and formerly incarcerated individuals to assess the importance of various standards.
A Focus on Alignment and Early Intervention
Notably, accreditation did not require additional staff or large capital investments. Instead, it focused on:
- Aligning Custody and Medical Staff: Improving communication and collaboration to ensure health care goals are met.
- Early Screening and Processing: Providing crucial guidance for processing and screening individuals during their first days in custody, a period when mortality risks are highest.
The Takeaway
This landmark study proves that NCCHC accreditation is not just a stamp of approval—it is a life-saving initiative that improves health outcomes, reduces recidivism, and delivers substantial cost savings. For jails looking to elevate their health care standards and enhance both staff and inmate outcomes, accreditation is a clear path forward.
