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 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."
Private hospitals more likely to transfer uninsured
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."
http://www.msnbc.msn.com/id/33971846/ns/health-health_care/
Image source: http://newsblog.projo.com/ACCIDENT%20MM.JPG
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- xiola
- added this
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Another reason why the government needs to step in and get the health coverage package done ASAP, that way it can save lives and stop making doctors Millionaires!!
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Well, we certainly need some kind of reform. My husband and I are self-employed and work very hard toward the "American Dream", and we cannot afford insurance. No way. So now I know I better be extra-careful. Something's gotta give.
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Often people who don't have adequate insurance are released from the hospital sooner than people with insurance. Getting patients in and out of the hospital as fast as possible leads too inadequate and incomplete treatment. Doctors who fear they may not receive total payment may forgo necessary surgery on uninsured patients. Some emergency mental health clinics use the criteria that people, regardless of the severity of their condition, must be suicidal before being admitted too a hospital ward. This is their method of weeding out the uninsured. We must not continue to allow so many people too die and suffer because of these practices. We need health reform now.
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Well that's very scary...I'm a young college student with a few skeletal birth defects so insurance is simply not an option for me.
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A dirty little secret when they see a Medicare card they assume you have quit trying so they quit trying too. Carrying a Medicare card with a Humana backup will get you the same treatment. You don't Ever want a Medicare card. It tells them NOT to treat you, to let you die is what it says to them.
That's what helped drive me to make my health formula => http://tinyurl.com/doctorbillsvaccine my tonic does everything just read this updated info => http://tinyurl.com/200yearsyoung <> you take this liquid health dynamite you may not visit a doctor for 20 years.
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- Gravity_Man
- 8 days ago
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I worked in the ER for 3 years and let me tell this is so true. I don't know how many people die waiting to see if they have insurance and if somebody that has insurance comes in even if the patient without insurance will wait because the insured gets done first.Very sad.
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- karenazimi
- 7 days ago
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I dunno.
I went to the ER with an ear infection 2 weeks ago. My ear canal was swollen shut and I had a fever for days that fluctuated up to 102.
I was told it was close to going septic and it may have gone to my heart had I not gone in.
Although I never was admitted to a room I stayed in triage for almost 30 hrs on a drip among other things until my fever went away.I was then sent home with a two week supply of cipro @ 500 mgs, amoxicillian @ 500 mgs, a steroid pack and 2 refills for vicadin @ 500 mgs.
I am not insured.
I know it was not "TRAUMATIC" injury but it could have been fatal non the less.-
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- JulianCommongold
- 7 days ago
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KSirys.... you have no idea what you are talking about. Stop making doctors millionaires???!!??? Last time I checked the average salary for a primary care physician was somewhere around 130,000 a year. He is also assuming a huge amount of debt in loans (250,000 by the time I'm done) along with a huge amount of responsibility for peoples lives. You may want to inform yourself before you speak. To make it sound like docs don't care about their patients is absurd... it's more complicated than you make it sound with your misinformation.
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My last doctor ran a neat scam having patients sit first in the front waiting room, then the hallway, then the exam room, all time there AFTER SIGNING IN => legally establishing his time spent per patient. He charged $350 to Medicare sent me a bill for $100 which I refused to pay because he only spent 5 minutes with me AND didn't help me. <>
Four years and some change later he still tries to collect. Boxley Hill Clinic, go there and find out for yourself. You go in then you come out and you're still sick, just like Roanoke Virginia hospitals all one big rip-off bunch of scam artists. You go in sick and obese, they treat what they want but they do NOT treat your obesity (so you will be sure to come back again soon y'all). <>
Texas tea, gold in Beverly Hills and Roanoke Va => Pride of the southern hemisphere for retarded medical care. Malpractice? They own it and you never get it. No one should move to Virginia, no one should visit Virginia & no one should drive through the Commonwealth of Virginia <> this is a marked land. <>
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- Gravity_Man
- 7 days ago
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I have transported hundreds of people to the hospital. Never have I seen a difference in the quality of care determined by ability to pay. What a crock.
I would look at lifestyle differences related to the two groups. -
Insurance is scam - they have inflated healthcare so that halrf of us can't afford it. All of them taking too much.
I got a bill from an emergency room visit - where the charge for a ten cent pill was $100.When you charge $100 for a ten cent item, - thinking you're really making out by ripping someone off, - you destroy the value of every $100 bill in the country. Suddenly everybody has to charge more and more and more.
The whole time the ten cent items are still worth no more than ten cents. It is just the money-base itself that is ruined - and everybody is running faster and faster on a tread-mill that doesn't feel good to anyone.
In short, these kinds of abuses are criminal - in that they ruin the lives of many and hold down the potential of the whole country.
Look at us now.
You got to to deliver a buck's worth of goods - for a buck.
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Paratus, you make a good scientific point regarding the difference between correlation and causation. Do low income people who can't afford insurance also lead unhealthy lives (smoking, fast food)? If so, does that affect their ability to survive a traumatic accident?
These are good questions, but a little common sense can also be useful. Hospitals are in business, and if they fold no one gets helped. They are incentivized to get as much money as they can from the insured and spend as little time as possible treating the uninsured.
This study is not the silver bullet of the health care debate, but when you look at all the evidence as a whole, it is clear that the system needs to be changed so that the players - who are, I hope, by and large, good people - can be good people.
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Ooh get that health care through fast...so it can start RIGHT AWAY in 5 years.
Anyway it won't matter because even with the Bill there will still be people WITHOUT INSURANCE.
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The simple reason is, Insured people are mor elikely to have regular checkups to keep as healthy as they can , whereas the uninsured may not be able to afford to do that, and this shows that their health suffers
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This is so terribly tragic and why we need to have insurance coverage for all of our citizens.
