Skip to comments.Uninsured Twice as Likely to Die in ER
Posted on 11/17/2009 12:18:02 PM PST by presidio9
Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study.
The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable.
"This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States," said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist.
The study, appearing in the November issue of Archives of Surgery, comes as Congress is debating the expansion of health insurance coverage to millions more Americans. It could add fodder to that debate.
The United States is the only developed nation that does not have a comprehensive national health care plan for all its citizens, leaving about 50 million of America's roughly 300 million people uninsured. President Barack Obama, who took office in January, campaigned on a promise of offering affordable health care to all Americans.
The researchers couldn't pin down the reasons behind the differences they found. The uninsured might experience more delays being transferred from hospital to hospital. Or they might get different care. Or they could have more trouble communicating with doctors.
The hospitals that treat them also could have fewer resources.
"Those hospitals tend to be financially strapped, not have the same level of staffing, not have the same level of surgeons and testing and equipment," Gawande said. "That also is likely a major contributor."
Gawande favors health care reform and has frequently written about the inequities of the current system.
The researchers took into account the severity of the injuries and the patients' race, gender and age. After those adjustments, they still found the uninsured were 80 percent more likely to die than those with insurance even low-income patients insured by the government's Medicaid program.
"I'm really surprised," said Dr. Eric Lavonas of the American College of Emergency Physicians and a doctor at Denver Health Medical Center. "It's well known that people without health insurance don't get the same quality of health care in this country, but I would have thought that this group of patients would be the least vulnerable."
Some private hospitals are more likely to transfer an uninsured patient than an insured patient, said Lavonas, who wasn't involved in the new research.
"Sometimes we get patients transferred and we suspect they're being transferred because of payment issues," he said. "The transferring physician says, 'We're not able to handle this."'
Federal law requires hospital ERs to treat all patients who are medically unstable. But hospitals can transfer patients, or send them away, once they're stabilized. A transfer could worsen a patient's condition by delaying treatment.
The researchers analyzed data on nearly 690,000 U.S. patients from 2002 through 2006. Burn patients were not included, nor were people who were treated and released, or dead on arrival.
In the study, the overall death rate was 4.7 percent, so most emergency room patients survived their injuries. The commercially insured patients had a death rate of 3.3 percent. The uninsured patients' death rate was 5.7 percent. Those rates were before the adjustments for other risk factors.
The findings are based on an analysis of data from the National Trauma Data Bank, which includes more than 900 U.S. hospitals.
"We have to take the findings very seriously," said lead author Dr. Heather Rosen, a surgery resident at Los Angeles County Hospital, who found similar results when she analyzed children's trauma data for an earlier study. "This affects every person, of every age, of every race."
LOL ... this is what qualifies as new to the lamestream media.
I call made up.
BS...hospitals are required by law to treat every ER patient regardless of ability to pay. If it were otherwise hospitals would all be profitable and there would be no waiting in a room full of uninsured people with runny noses and a cough looking for primary care.
Believe CBS? Weren’t they the folks who hired Dan Rather?
Hell, I wouldn’t trust CBS with a three minute egg.
You’re more polite than I am. I was going to call bull$hit
Statistically speaking, this would be because people who are uninsured tend to have other characteristics that make them more prone to premature death — drug and alcohol addiction, little education, general irresponsibility, etc. Obviously that doesn’t describe everybody who’s uninsured, but you can be pretty sure that the vast majority of gangbangers, drug addicts, prostitutes, general deadbeats, etc, who show up in hospital emergency rooms are uninsured, and they tend to arrive with a long history of poor personal health care and some underlying conditions which aggravate the condition they’re seeking treatment for.
Many people choose not to become insured, and they may make poor health choices otherwise and don’t visit an ER until they have accumulated problems. On most ER visits I’ve had, insurance uis not discussed until the triage is done.
This is ridiculous.
More DNCBS lies. These stats are cooked.
Pray for America’s Freedom
And twice-as-likely to be carried in with an OD.
Some private hospitals are more likely to transfer an uninsured patient than an insured patient, said Lavonas, who wasn’t involved in the new research.
Michelle Obama may know a little about THAT one.
Now it makes perfect sense...no need for a disclaimer there doc.
Nah...it's true. In fact, one episode of Sons of Anarchy dealt with a biker that had to be moved to another hospital, because he had the wrong insurance.
If you can't believe the veracity of Sons of Anarchy, a mini-series about a fictional biker club, then who can you believe?
They need to do a breakdown by percentage insured at the hospital, i.e hospitals with 0-25% patients having no insurance, 25-50% and so on. Maybe it’s the hospital or the setting - urban vs. suburban. Maybe it’s pre-existing conditions - if you are a diabetic or immuno-suppressed, you are less likely to survive your trauma.
I’ve been with an uninsured friend to more than a couple hospitals and ERs..
The ER staff has never, EVER been concerned with the payment part. If I heard it said once, I heard it a hundred times, “don’t worry about that now, we’ll get you better first”.
Lies, damn lies, and statistics. I think this falls in the last of the three categories.
I call BS.
BUT, if it were true, then it would mean that doctors are killing people in ER and they should be locked up.
When will a national Task Force be created to investigate and arrest these killer doctors, nurses and administrators, and shut down those hospitals.
Again, I call BS.
No kidding LOL...so how you live your life has nothing to do w/ this then. Its all about not having ins. Right.....
Then they should just not go there.
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