Gender Differences and the Effect of Copayments on the Utilization of Health Care in Prison.

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.