Accident Patients without Health Insurance Have Higher Mortality

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If you are the victim of an auto accident or gunshot wound and you don’t have health insurance, you are more likely to die of your injuries than if you have private insurance. This statistic comes from University Buffalo researchers who also found that accident patients with Medicaid had a lower death rate than those who had private insurance.

As the country continues to ponder and debate over health insurance costs, coverage, and options, researchers are finding that the cost of not having health insurance can be deadly for many people. A recent study published in the Journal of Hospital Medicine, for example, reported that an uninsured person’s chances of dying if hospitalized for a heart attack, stroke, or pneumonia are significantly greater than if he or she had private health insurance. Data from the Institutes of Medicine show that tens of thousands of people die each year due to lack of insurance.

The University Buffalo (UB) study consisted of an evaluation of data from the national Trauma Data Bank for 2001-2005 and included 191,666 patients between the ages of 18 and 30, which eliminated individuals who were more likely to have chronic health conditions. The study population came from 649 facilities and included 150,332 patients who had suffered blunt trauma (mostly motor vehicle accidents, but also falls or assaults) and 41,334 who had penetrating trauma, mostly gunshot wounds but also stabbings.

The fact that uninsured patients had a higher mortality rate raises questions. Dietrich Jehle, MD, UB professor of emergency medicine and the first author on the study, noted that “Generally we don’t know a trauma patient’s insurance status when we treat them initially in the emergency department, which makes us ask if there are differences in these populations other than the delivery of care.”

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Jehle also pointed out that “uninsured adult patients in general have a 25 percent greater mortality rate than insured adults for all medical conditions,” and so the study’s findings are not so surprising. Lack of health insurance can cause people to delay getting treatment, and people without insurance generally are in poorer health, says Jehle, which would reduce their ability to survive trauma.

Other factors that could affect mortality include a reluctance to seek medical care by certain ethnic groups because of language barriers, or that the uninsured are more likely to drive older, less safe vehicles.

The study also found, however, that patients on Medicaid who suffered injury in a motor vehicle accident had a lower death rate than people who had private insurance, which suggests that factors other than the amount of payment for medical services influences the outcome of trauma care.

Jehle suggests that having universal health coverage could have a positive impact on the population that they studied. “For instance,” he noted, “there would be no need for patients to delay treatment with universal health coverage, and such coverage could improve the overall health status of injury victims and increase their survival rates.” It remains to be seen how the new health insurance and health reform laws will impact mortality among accident patients and other health care consumers.

SOURCES:
Buffalo University news release June 11, 2010
Dorn S. Uninsured and dying because of it. Institute of Medicine analysis on the impact of uninsurance on mortality. 2008.
Hasan O et al. Journal of Hospital Medicine 2010; DOI: 10.1002/jhm.687

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