Healthcare in jails

The first stop (post-arrest, pre-trial) for many people caught up in the US criminal justice system  is a local jail.  Many of the people who are jailed have healthcare issues involving, for example, mental illness and/or drug and alcohol addiction.  But jails don't view themselves as healthcare facilities.

So I'm glad to see that Stanford Impact Labs (SIL) is funding

Improving Medical Care for People Affected by Incarceration (IMPACT) 

"Local jails are a critical but often overlooked part of the American healthcare system, processing approximately 7.3 million admissions annually and housing more than 600,000 individuals on any given day. Despite this scale, healthcare quality in jails remains highly variable, and mortality rates have increased over time, with drug and alcohol-related deaths increasing as much as four times from 2000 to 2019 and suicide rates remaining approximately twice the national average.

"Our research project addresses this challenge by identifying and scaling organizational strategies to improve healthcare quality, coordination, and oversight in local jails. Building on the first randomized controlled trial of healthcare accreditation in U.S. jails, our team partnered with 46 jails nationwide to evaluate accreditation through the National Commission on Correctional Health Care (NCCHC). We found that accreditation improved compliance with healthcare quality standards, particularly in training and patient care, and reduced 12-month mortality by approximately 60 percent. These improvements happened without increases in staffing or capital investments, suggesting that organizational improvements and better coordination drive impact.

"The current phase of the project focuses on understanding how jail leaders, including sheriffs, make decisions about improving healthcare quality in local jails. Through our partnership with the National Sheriffs' Association, we aim to identify the factors that influence the adoption and implementation of healthcare improvement strategies, including voluntary healthcare accreditation and other evidence-based approaches. Through this partnership, we plan to translate evidence into sustainable improvements in correctional healthcare systems nationwide. 

 

Team
Marcella Alsan
Professor, Stanford Economics

Meghan Beal
Director, I.G.N.I.T.E., National Sheriffs' Association

Crystal Yang
Professor, Law, Harvard Law School

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Other posts about SIL supported work.

 

Stanford Impact Labs announces support for kidney exchange in Brazil, India, and the U.S.

 Stanford Impact Labs has announced an investment designed to help the Alliance for Paired Kidney Donation (APKD) increase access to kidney exchange in Brazil, India, and the U.S.  Here are three related web pages...

1. Stanford Impact Labs Invests in Global Collaboration to Increase Access to Kidney Transplants.  $1.5 million over three years will support solutions-focused project led by Stanford’s Dr. Alvin Roth and the Alliance for Paired Kidney Donation (APKD)  by Kate Green Tripp

"Stanford Impact Labs (SIL) is delighted to announce a $1.5 million Stage 3: Amplify Impact investment to support Extending Kidney Exchange, a solutions-focused project established to increase access to lifesaving kidney transplants.

"The team, led by Stanford’s Dr. Alvin (Al) Roth, who shared the 2012 Nobel Prize in Economics for his work on market design, and the Alliance for Paired Kidney Donation (APKD) is working in close partnership with organ transplant specialists and medical centers in Brazil, India, and the U.S., including Santa Casa de Misericórdia de Juiz de Fora, the Institute of Kidney Diseases and Research Center and Dr. H L Trivedi Institute of Transplantation Sciences (IKDRC-ITS), and Walter Reed National Military Medical Center.

"Over the course of the next three years, the team aims to increase the number of transplant opportunities available to patients who need them by creating and growing kidney exchange programs in Brazil and India, where millions of people suffer from kidney disease yet exchange is minimal; and explore the effects of initiating donor chains with a deceased donor kidney (DDIC) in the U.S., an approach which could unlock hundreds more transplants each year.

..."

2. How Does Applied Economics Maximize Kidney Transplants? A project aimed at expanding kidney exchange and saving lives puts Nobel Prize-winning matching theory into practice.  by Jenn Brown   (including a video...)

"APKD uses open source software developed by Itai Ashlagi, Professor of Management Science and Engineering at Stanford University, to facilitate the matching process for its NEAD chains, and they currently average 5 non-simultaneous transplants per chain.

3. Extending Kidney Exchange

"In Brazil, our team has launched a kidney exchange program within Santa Casa de Misericórdia de Juiz de Fora and Hospital Clínicas FMUSP in São Paulo and aims to expand to facilitating exchanges between these centers and others with the ultimate goal of kidney exchange transitioning from a research project to an officially approved practice in Brazil.

"In India, our team has deployed kidney matching software and resources for growth to the Institute of Kidney Diseases and Research Center and Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS) to support kidney exchange programs. We aim to develop an evidence base for potential updates to organ transplantation laws that expand criteria for who can give and receive lifesaving kidneys.

"In the U.S., we are working with Walter Reed National Military Medical Center to test the use of deceased donor-initiated chains (DDIC) so as to generate hundreds of additional life-saving transplants each year that are not currently supported by today's practice of utilizing a deceased donor kidney to save the life of a single person on a transplant waitlist. "

 

Kidney exchange in India (one minute video)

In India, which already does the third most kidney transplants in the world (after the US and China), physicians and surgeons are making great progress on kidney exchange.

  Some of this progress is with the help of the Alliance for Paired Kidney Exchange (APKD), supported by a grant from Stanford Impact Labs (SIL)

 Here's a short video about that collaboration, narrated by Mike Rees, the founder and guiding light of the APKD.

 The picture below was taken just after Mike Rees (on the left) and I observed a robotic kidney transplant surgery performed by  Dr. Pranjal Modi (on the right), in Ahmedabad 

 

  

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Earlier:

Thursday, January 22, 2026  Kidney exchange in Brazil (a clinical trial)

 

Stanford kidney conference, recap

 Stanford Impact Labs (SIL) reports on our recent kidney exchange conference

Global Solutions-focused Summit on Expanding Access to Kidney Transplantation held at Stanford. Physicians, scholars, healthcare practitioners, and policymakers gathered to explore research advances underway in India, Brazil, and the U.S.   by Kate Green Tripp and Marina Kaneko

 "Earlier this month, the Alliance for Paired Kidney Donation (APKD), Stanford economist Alvin E. Roth, and Stanford Impact Labs hosted the Palo Alto Summit, a two-day global convening at Stanford University dedicated to exploring challenges and advances in kidney transplantation around the world.

"On the heels of the 2025 World Transplant Congress in San Francisco, more than 30 physicians, scholars, transplant coordinators, and government officials from the U.S., India, Brazil, Italy, the United Arab Emirates, Qatar, and South Africa gathered to share key learnings, challenges, and advances in the field.

...

" APKD and Roth, the Craig and Susan McCaw Professor of Economics at Stanford’s School of Humanities and Sciences, have teamed up with transplant specialists in India, Brazil, and the United States to form the Extending Kidney Exchange project. 

...

"The summit’s sessions were designed to advance national efforts in KPD in India and Brazil, and deceased donor-initiated chains (DDIC); foster collaboration among leading clinical, policy, and academic partners; and identify actionable steps and shared milestones for KPD in India and Brazil, paired liver exchange in India, and DDIC in the United States. As a transplant strategy, DDIC utilizes kidneys from deceased donors to create a chain of transplants so as to maximize the use of available organs and to connect multiple recipients, especially when there are mismatches or compatibility issues.

...

"“When the very first [nonsimultaneous] chain of kidney transplants took place in 2006, it was not necessarily welcomed as an innovation,” recalls Michael Rees, a transplant surgeon at the University of Toledo and founder of the Alliance for Paired Kidney Donation (APKD). “It is incredibly exciting to reflect on the progress we’ve been able to make across the transplant community since that time, to increase the utility of a single kidney from either a living or deceased donor.”

 

 

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Earlier:

Thursday, August 7, 2025 Stanford conference on extending kidney exchange

 

Also of note:

Matthew Gentzkow Named Director of Stanford Impact Labs

"The economist will lead a community of social scientists who want their scholarship to improve people’s lives."