The report is derived from (1) a systemwide examination of Bureau of Prison (BOP) health care delivery based on 10 randomly selected institutions, (2) case studies of six BOP institutions, and (3) a management study of the metropolitan correctional centers and jails in the BOP. From a sample of several thousand inmate medical records for fiscal 1978 among 16 Federal prisons, it is concluded that the health status of the inmate population is, with some notable exceptions, reasonably similar to that of the general population in similar age groups. For mental disorders, hepatitis, and arthritis/rheumatism, inmate sickness rates seem high compared to the general population. Inmate use of health services (medical and dental encounters per inmate per year) is five times the level reported for the general population. Physician staffing appears to be adequate for the 10 prisons site-visited. This conclusion is based on encounter rates for various types of medical personnel, health status of the inmate population, physician time available for direct patient care, and the peculiarities of the institutions visited. Recommendations are offered for reducing the demand for inmate health care services and for reducing staffing shortages. Tabular data are provided.