When uninsured patients are treated in the hospital for heart attack, stroke and pneumonia, they are 50 percent more likely than privately insured patients to die from the conditions during their hospital stay, reports a new study published in the Journal of Hospital Medicine.
Researchers from Harvard Medical School and Brigham and Women's Hospital in Massachusetts investigated the effect of insurance coverage on hospital care by analyzing the discharge data of more than 150 thousand adults between ages 18 and 64.
Compared with hospitalized patients who have insurance, the team found that uninsured patients were 52 percent more likely to die in the hospital after a heart attack and 49 percent more likely to die in the hospital after a stroke. Patients on Medicaid were 21 percent more likely to die in the hospital while receiving treatment for pneumonia.
Although numerous studies have focused on insurance related disparities in the outpatient setting, few nationally representative studies have examined such disparities among hospitalized patients, notes the Medical News. The current study is a retrospective database analysis of 154,381 adult discharges with a principal diagnosis of acute myocardial infarction, stroke or pneumonia from the 2005 Nationwide Inpatient Sample.
"We hope that the results of our study will broach a national dialogue on whether provider sensitivity to insurance status or unmeasured sociodemographic and clinical prognostic factors are responsible for the observed disparities and stimulate additional research to find answers to these questions," said lead author Dr. Omar Hasan.
According to Hasan, three leading reasons for the disparities include uninsured patients' tendencies to delay care, hospitals' avoidances of performing high-cost procedures on the uninsured and a possibility that the uninsured receive substandard care.
"The new healthcare bill will bring vast changes to the insurance status of millions of Americans, and we hope that our work will provoke policymakers, healthcare administrators, and practicing physicians to consider devising policies to address potential insurance related gaps in the quality of inpatient care," Hasan wrote.