Patients with private insurance receive better hospital care than those without it, according to a new study published in Health Affairs.
Researchers compared the Agency for Healthcare Research and Quality's Inpatient Quality Indicators to 2006-2008 State Inpatient Database records from 11 states. Using these measures, patients with private insurance had lower risk-adjustment mortality rates than Medicare beneficiaries for 12 out of 15 procedures and conditions, according to lead author Christine S. Spencer, an associate professor and executive director of the school of health and human services in the college of public affairs at the University of Baltimore, and her team.
The difference in care is significant. For example, mortality rates for Medicare patients were 104 percent higher for hip replacements and 102 percent higher for esophageal resection. Medicare patients had an average of 5.85 more deaths per 1,000 patients than patients with private insurance at the same hospital, according to the study.
Privately insured patients also had lower mortality rates than those in other payer groups, albeit to a lesser extent, according to the study. The only procedures for which patients with private insurance had higher mortality rates than Medicare patients were pneumonia, stroke and congestive heart failure.
"Medicare patients appeared particularly vulnerable to receiving inferior care," the study's authors wrote. "These findings suggest that to help reduce care disparities, public payers and hospitals should measure care quality for different insurance groups and monitor differences in treatment practices within hospitals."
The authors suggest several possible reasons for the disparity, including delays or restrictions in care and unequal access to newer technology. Privately insured patients also may have doctors who provide them with more individualized treatment, or have access to "newer, more expensive treatments," the study said.
An April study found Medicare patient mortality rates were on the rise in critical access hospitals, but had declined in other hospitals over the past decade, FierceHealthcare previously reported.
To learn more:
- here's the study abstract