#1
Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study.

"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."

...

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.


News article: http://www.msnbc.msn.com/id/33971846/ns/health-health_care/
Study: http://archsurg.ama-assn.org/cgi/content/full/144/11/1006
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"Knowledge is in every country the surest basis of public happiness."
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#3
Bah, how does the study take into account variables such as the differences in the NOI/MOIs of those insured and those uninsured? As they're generally different demographics and one generally has more money than the other, certain sides probably lean higher towards one sort of injury/illness over another.

Moreover, maybe many of those uninsured delayed going to the ER because they were worried of financial difficulty?

I'm for the new health coverage and universal coverage as well, but I feel that this study is an inappopriate one to use to try to explain whether or not, and how, hospitals/trauma centers treat uninsured differently from insured.
My God, it's full of stars!
#7
The ER I work in sees about 200 patients a day, and we're a level 2 trauma center in a private hospital. Roughly 80% of our patients have Medicare, Medicaid, or are uninsured, which means my doctors are getting paid pennies on the dollar for their work. Luckily, they are all awesome people, and we rarely transfer people out due to payment issues. Alot of people treat our ER like it's a clinic, but our doctors know that sometimes, that's the only health care those people can get, so they provide it anyway. It makes me glad to work there, instead of a place based on making profits like the one in the news article.
#8
Quote by Dreadnought
Bah, how does the study take into account variables such as the differences in the NOI/MOIs of those insured and those uninsured? As they're generally different demographics and one generally has more money than the other, certain sides probably lean higher towards one sort of injury/illness over another.

Moreover, maybe many of those uninsured delayed going to the ER because they were worried of financial difficulty?

I'm for the new health coverage and universal coverage as well, but I feel that this study is an inappopriate one to use to try to explain whether or not, and how, hospitals/trauma centers treat uninsured differently from insured.

Read the study, they controlled for such variables, in part by having a massive sample size.
Hell, just read the abstract:

Patients Data from patients (age, ≥18 years; n = 687 091) with similar age, race, injury severity, sex, and injury mechanism were evaluated for differences in mortality by payer status.

Main Outcome Measure In-hospital death after blunt or penetrating traumatic injury.

Results Crude analysis revealed a higher mortality for uninsured patients (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.36-1.42; P < .001). Controlling for sex, race, age, Injury Severity Score, Revised Trauma Score, and injury mechanism (adjusted for clustering on hospital), uninsured patients had the highest mortality (OR, 1.80; 95% CI, 1.61-2.02; P < .001). Subgroup analysis of young patients unlikely to have comorbidities revealed higher mortality for uninsured patients (OR, 1.89; 95% CI, 1.66-2.15; P < .001), as did subgroup analyses of patients with head injuries (OR, 1.65; 95% CI, 1.42-1.90; P < .001) and patients with 1 or more comorbidities (OR, 1.52; 95% CI, 1.30-1.78; P < .001).

Conclusions Uninsured Americans have a higher adjusted mortality rate after trauma. Treatment delay, different care (via receipt of fewer diagnostic tests), and decreased health literacy are possible mechanisms.



Quote by JDawg
Doubt it. Anyone setting foot in an ER in the US is getting help.

Lulz.
"You have evidence and data you say? Who needs it, I believe what I want"
"Why should we subsidise intellectual curiosity?"
-Ronald Reagan

"Knowledge is in every country the surest basis of public happiness."
-George Washington
Last edited by Ur all $h1t at Nov 18, 2009,
#9
Quote by Ur all $h1t
Read the study, they controlled for such variables, in part by having a massive sample size.
Hell, just read the abstract:




Thanks for posting that, don't have time to read the whole article.
My God, it's full of stars!
#10
Quote by Ur all $h1t


Lulz.
"You have evidence and data you say? Who needs it, I believe what I want"


Well, you win. I guess the only way to fix it is to force people to get insurance and punish those who don't, right?
#11
Quote by CrazyDavey
aren't you SUPPOSED to have health insurance?


well, it's a good thing to have, but lots of people can't afford it.
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#12
Quote by Pagan-Pie
Sigh.


*Waits for inevitable socialised v. private healhcare fight*

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#13
Quote by JDawg
Well, you win. I guess the only way to fix it is to force people to get insurance and punish those who don't, right?


no, that's a stupid bullshit way to handle it, the best way is to adopt a single payer system.
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#14
Reminds me of Scrubs and Dr. Kelso.
Quote by Zinnie
god placed the fossils in earth to confuse the humans into thinking that earth is older than it actually is, therefore, making men try and think outside the box....

just kidding, there is no god



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#15
Quote by JDawg
Well, you win. I guess the only way to fix it is to force people to get insurance and punish those who don't, right?

Nah, the best way is to have a healthcare system that is free at the point of access for all citizens and funded through a progressive taxation system.
"Why should we subsidise intellectual curiosity?"
-Ronald Reagan

"Knowledge is in every country the surest basis of public happiness."
-George Washington
#16
See the thing about healthcare is I think that they should make it affordable without health insurance. They price gouge the hell out of everything due to malpractice suits and people not being able to pay when they get service in an ER. I'm not sure how they'd do it, but I think that'd be the best solution. Also, why is everyone who isn't an American worried about America's health coverage?
Due what you want as long as you vote Due!
#17
Quote by Ur all $h1t
Nah, the best way is to have a healthcare system that is free at the point of access for all citizens and funded through a progressive taxation system.




I'd always suspected this but never actually looked for evidence.
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