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."
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?
Screw Them!
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.
Treat them.
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?
Doctors and nurses don’t know if you have insurance. Are we supposed to believe the receptionist runs into the ER and tells the doctors to quit working on an uninsured patient? Insurance is the last thing on a doctor’s mind while he attends to patients in the ER.
The last time I was in the hospital, I wasn’t even asked about insurance until after I was admitted...from the emergency room.
| Contributor | Occupation | Date | Amount | Recipient |
|---|---|---|---|---|
| GAWANDE, ATUL WABAN,MA 02468 |
HARVARD UNIVERSITY/SURGEON WRITER | 9/29/06 | $750 | Feder, Judith (D) |
| GAWANDE, ATUL WABAN,MA 02468 |
BRIGHAM AND WOMEN'S PHYSICIAN ORGAN | 3/14/06 | $500 | Feder, Judith (D) |
| GAWANDE, ATUL NEWTON,MA 02461 |
THE BRIGHAM & WOMEN'S HOSPITAL/RESI | 2/25/04 | $300 | Torsella, Joseph M (D) |
| GAWANDE, ATUL NEWTON,MA 02461 |
SELF/AUTHOR/PHYSICIAN | 6/29/02 | $250 | Cooper, Jim (D) |
| GAWANDE, ATUL WABAN,MA 02468 |
HARVARD UNIVERSITY/BRIGHAM AND WOME | 6/27/06 | $250 | Feder, Judith (D) |
| GAWANDE, ATUL NEWTON,MA 02461 |
BRIGHAM AND WOMEN'S PHYSICIAN ORGAN | 5/16/04 | $250 | Kerry, John (D) |
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Other risk factors?? Like maybe drug use?
How would a doctor know if a patient has money or not?
Are there death panels that assess that sort of thing?
Well, the receptionists should be telling the doctors who is and who is not a paying customer.
If not, those who are responsible and actually carry health insurance will not receive adequate treatment as medical resources and my tax dollars are wasted on deadbeats who refuse to carry health insurance.
President used that same argument. Said “you could get hit by a bus”. City would be responsible for the damage caused to a civilian by an employee.
As would another driver in a car accident (or even on your own car insurance if you have Personal Injury Protection).
By your edict, fire insurance, flood insurance, and hurricane insurance should also be required under penalty of law for home owners and renters. No more “emergency bailouts”. Buy your insurance, cheapskate. The wizard of OZbama.
Is it risky for two men to engage in unprotected sex? Can we tax bathhouses and other places that harbor public anonymous sex?
Correlation does not equal causation. Uninsured people probably take worse care of themselves in general, live riskier lives, live closer to swamped/poor ghetto hospitals, and have different criteria for whether to go the ER.
I think I’ve got it.
A voluntary charity to pay for those who have to have lifesaving emergency room treatment.
We could solicit those who support gov’t healthcare first.
That would be a good idea, but for now, while few such charities exist, those who elect not to carry health insurance should not be treated in hospitals.
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