November 17, 2009

Living without health insurance? Don’t count on it

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We’re all familiar with the toll: 45,000 people die each year because they don’t have health insurance. Now comes some new insight into why that number might be even bigger:

rita_hibbardwebA study shows that people who don’t have health insurance are more likely to die from car accidents and other traumatic injuries, even though hospitals are required by law to treat all patients equally, regardless of whether they have insurance or not.

It’s no fluke. It was a huge study – nearly 700,000 patients who visited trauma centers nationwide between 2002 and 2006. And it found that the odds of dying after an accident injury were almost twice as high as for uninsured than for patients with private insurance, according to a report in the Los Angeles Times.

The study, reported in the Archives of Surgery and conducted by research teams from Harvard University and Brigham and Women’s Hospital in Boston, used information from 1,154 U.S. hospitals that contribute to the National Trauma Data Bank. They found the risk of death 80 percent higher for patients without any insurance, according to the report.

The researchers also did a separate analysis of 209,702 trauma patients between the ages of 18 and 30 because they were less likely to have chronic health conditions that might complicate their recoveries. Among these younger patients, the risk of death was 89 percent higher for the uninsured, the study found.

Theories abound. Some guess the uninsured have higher rates of underlying conditions. Maybe they wait longer or are transported from one hospital to another, worsening their conditions. They may be more passive with doctors and nurses because they don’t interact as often. Perhaps it’s simply a correlating factor – and more related to the type of injury – stabbing and gunshot victims are more often uninsured and more likely to die from their injuries. Docs are scratching their heads and looking to do more research.

“We don’t ask people, ‘What’s your insurance?’ before we decide whether to intubate them or put in a chest tube,” said Dr. Frank Zwemer, chief of emergency medicine for the McGuire Veterans Administration Medical Center in Richmond, Va., who wasn’t involved in the research. “That’s not on our radar anywhere.”

Meanwhile, 45 million Americans don’t have health insurance. And 10 million more are expected to join them in the next decade. And that 45,000 who die due to lack of insurance — that’s more than drunk driving and homicide combined.

— Rita Hibbard

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