Uninsured patients more likely to die from trauma than insured ones

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Washington, June 12 (ANI): A new study has shown that trauma patients without insurance are more likely to die of their injuries from auto accidents and gunshot wounds than privately insured patients with similar injuries.

The findings are based on an analysis of 193,804 patients from 649 facilities conducted by University Buffalo emergency medicine physicians.

In addition, the authors found that Medicaid patients who were injured in motor vehicle accidents had a lower death rate than those with private insurance, indicating that factors other than the level of financial remuneration for medical services are influencing trauma outcomes.

Patients covered by any of the insurance plans studied-Medicaid, Medicare, private and managed care organizations such as HMOs-had better mortality rates for all injuries than persons without insurance, the analysis showed.

Dietrich Jehle, UB professor of emergency medicine and first author on the study, said that these findings suggest that the causes of this difference are many and probably are not based just on quality of care.

"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. This finding was a little surprising," said Jehle.

"Both race and insurance status are independent predictors of mortality rates for trauma outcomes, and of the two, insurance status, specifically lack of coverage, is the most significant.

"This is not unexpected, since uninsured adult patients in general have a 25 percent greater morality rate than insured adults for all medical conditions," Jehle added.

Lack of insurance could influence mortality in a number of ways, noted Jehle. With no way to pay for care, persons may delay getting treatment. Those without insurance frequently are from ethnic groups who face language or literacy problems, and may be afraid to go to a hospital.

Other factors could include differences in risk-taking behaviors. Studies have shown a relationship between not wearing seat belts and lack of health insurance, and that the uninsured are likely to drive older, less safe vehicles.

In addition, said Jehle, people without insurance have poorer health status in general, which would lessen their ability to survive a traumatic injury, and they often are treated differently.

"Research shows that, for other than trauma injuries, the uninsured may actually receive less aggressive treatment and fewer diagnostic procedures," he said.

Results of the study were presented June 4 at the 2010 Society for Academic Emergency Medicine Annual Meeting in Phoenix, Ariz. (ANI)

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