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."
Tax them no more than we tax singles bars where straight people hook-up and have unprotected sex.
Someone had it here, I laughed like mad, so I lifted it and put it on my photobucket page...
People who don't have that are generally less likely to take care of themselves and as a result to be in poor health and consequently in worse condition and less survivable when they show up.
It's and indicator of the nature of the patient, not the health care provider.
Actually, that goes against my 22 years of experience in prehospital care. We had a saying that the odds of surviving a traumatic injury were inversely proportional to the number of homemade tattoos the victim had or their relative worth to society.
Not BS at all. The key term is "medically unstable." That, they have to treat. That doesn't cover much.
Otherwise, it's easy enough to find out. Go to a hospital ER, tell them you have some non-emergency ailment, serious enough but not an emergency situation; say you're having real bad ear pain with dizziness and nausea, or you haven't been able to swallow solids for a year and your heartburn is making you severely undernourished, or you've got such intense gall bladder pain you can't function anymore. Then tell them you have no insurance, no job, no medicare, no medicaid, no ability whatsoever to pay them. You don't own a home and there's no gold in your teeth. See how much medical attention the law requires them to give you. You get a free pass right out the door to the curb.
Like everyone else here, I don't think free medical care is free, or that anyone should be forced to pay for their fellow citizens' care. But the argument that it's already happening is false.
All you needed to do was to say Rev Wright is this guy’s preacher?
Homosexuals are more likely to be carriers and more likely to engage in public sex.
While both heterosexuals and homosexuals may engage in public sex in a bar, both have relatively low occurance compared to bathhouses which tend to be strictly same sex.
But keep on with your blind prejudices.
IAs with GSWs
If this propaganda study is real, where are all the dead illegal aliens???????
The uninsured are more likely to be drug users, go bankrupt, be unemployed, engage in criminal activities too...
Those traits could affect their medical outcome... Here's another little known fact - the most important car insurance "addition" to have is uninsured motorist... why? Because people without car insurance are the ones most likely to cause car accidents. They don't have insurance because some or all of the following: they're irresponsible, they've had so many DUI's their rates are incredibly high, they caused so many accidents - again way high rates, they've lost their license and are driving illegally...etc.
I’d say we’re at #5/6.
There is so much here that is just made up to try and bail out our failing dear reader.
Maybe, but in 2006 there were 119000000 ER visits with 17% of the people being uninsured. That's 20,230,000. I don't think that there are that many drug dealers and gang bangers in the US. I'm going to stick with my original assessment as tendentious bullsh!t with absolutely no factual merit at all.
Odd how Harvard University researchers missed something so obvious that all of us out here in the real world already know it...
Exactly.
It’s like saying people without car insurance are most likely to have an accident and total their car. So what?
"Die in the ER"? What does that mean, actually dying in the ED or does it mean dying later of the presenting injuries in the OR or on the floor?
For crying out loud. Nobody knows the insurance status of a trauma patient!
Douglas (director of the division of sexually transmitted diseases at the U.S. Centers for Disease Control and Prevention) said children and teens need to know about condom use, and should limit their number of sex partners and avoid sex with people who do have many other sex partners."If you are a man who has sex with men you ought to be getting a battery of STD tests every year," Douglas added.
What a stretch of data! IMHO there could be other reasons other than insurance coverage? How about that they like take chances more than those who plan a head?
These are the people who under ObamaCare will get insurance for free..
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