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ER No Free Ride For The Uninsured

Mon, 11/16/2009 - 3:37pm

Carla K. Johnson, AP

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 new study. The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable.

The study appears in the November issue of Archives of Surgery. Researchers couldn't pin down the reasons behind the differences. 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.

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.

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. 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.

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