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.
OTOH, gay men, who have a life expectancy of 42 years, due to the same issues of alcoholism, drug use, suicide, suceptibility to fatal STDs, smoking, and high risk taking, tend to be disproportionately better insured.
Just playing devil’s advocate here.
Of course, gay men only make up about 1% of the adult population, so there’s that to consider as well.
These are the same folks who are not going to pay for insurance under any circumstances.
GSW parients with no insurance die more frequently then those who do. And there is a down side how?
So they lumped together car crashes, falls and gunshot wounds and then pretended to adjust the data to "take into account the severity of the injuries"?
This is probably how they fudged the data, by purporting to equate a category like "gunshot wounds" with "automobile crashes" as equally severe.
So the problem of the gang-banging underclass becomes a problem of "lack of health insurance" and "not enough money spent on hospitals treating them."
And if we just pass nationalized health care, then "severe" inner-city gunshot victims will have the same survival rate as "severe" suburban auto crash victims! It's magic!
Yeah; from gunshot wounds, AIDS, STD’s, and a host of other SELF-INDULGENT/DEPENDENCY LIFESTYLE CHOICES that these parasites make.
Might be some merit to it.
Don’t you think there’d be a strong correlation between
engaging in risky behavior, say, dealing drugs or gang-bangin’,
and not being responsible enough to buy insurance?
The “researcher” cited as a senior author of the study is an advocate of Obamacare and a talked about replacement for Teddy’s seat.
I’m not wearing my glasses today, and first glance the title read:
Uninsured Twice as Likely to Die on FR.
Very well said and I’ll add illegals to your list
Trying to simplify cause and effect does not work. So many factors.
do people not get the whole correlation/causation thing? maybe people without insurance are more likely to not know how to drive, drive cars that are less safe, and generally have higher levels of destructive behaviors. sheesh!
Sounds like most of these patients were ambulance patients with not much choice about going to the ER. They were trauma, not medical so accumulated problems isn’t what got them there.
Uninsured patients MIGHT if they are alert and talking delay refuse to go to the hospital because they can’t afford it, and then be in worse shape when they do show up. Last week I had a patient who had a first-time seizure a few hours after an auto accident. He was alert and oriented by the time we got there and refusing to go in. Major persuasion and pressure by EMTs, medics, cops, his wife finally wore him down but here was a hard-working family man putting off an evaluation he needed because he was so worried about the money.
Twice as likely? Really.
I guess there’s nothing else for us to do than to turn the health care industry over to government bureaucrats because we all know how well that works out.
I doubt anyone except the most foolish will take this “study” seriously.
Substance-abusing street people and gang bangers don’t do as well as average people after traumatic injury. Who would have thunk it!
well now that you put it that way ... then it’s quite possible.
It will be noted that there is a law requiring ER's to take injured patients who show up for treatment.
However, there are also perfectly legal ways to dodge that law (I never heard of "patient dumping" before the law was passed). Hence the solution creates the problem.
Don't recall this being much of a problem before that law was passed in the '80's.
Of the 50 million people uninsured in the US, half are twice as likely to live in Arizona’s 15th district and half are twice as likely to be illegal aliens.
The other half are twice as likely to not exist...
But three times as likely to have voted for Obama.
Don't go interjecting logical explanations into emotionally-driven statistics!
It does seem to be over the heads of an awful lot of people . . .
I expect if you took random samples of insured vs. uninsured parents, and asked them how high a temperature their young child would have to have before they'd take the child to the emergency room, most of the insured parents would give you a reasonable number while a large percentage of the uninsured parents would say they have no idea, or that they don't have a thermometer in their home so would have no idea how high the child's temperature was. If you arrive at an emergency room already closer to death, you're more likely to die there, regardless of what treatment you get.
Under Peolsi care they just die in Jail? Is that the point?
If they do not have insurance, they should not be treated in the first place, since their treatment will end up being paid for by the American tax payer.
And don’t forget the “perverse incentive” angle that many don’t get either.
Leftists, in particular, are willfully obtuse when it comes to the effects of their policies on the behaviors of people.
Gosh, I wonder why people stay on unemployment longer when you increase the time and money allowed.
Gosh, I wonder why people on welfare don’t get jobs when we pay for everything they need.
Gosh, I wonder why people demand more healthcare when they don’t have to pay for it.
We at FR saw this coming a mile away.
Then get proof positive of their identity,
and don’t let them go until you have some method of assurance of payment.
BUNK. What an insult to the medical professionals in the ER rooms across America, this is BUNK.
No, those who elect to not carry health insurance are assuming a certain risk and in that deferring a financial risk on me, the American tax payer.
Why should I have to assume a financial risk simply because a few deadbeats refuse to purchase health insurance?