Uninsured 80% More Likely to Die in the E/R
Published November 23, 2009 @ 11:00AM PT
Trauma victims without health insurance are 80% more likely to die in the emergency room than their insured counterparts, even though E/Rs are mandated to treat equally all who come through their doors.
Brutal.
This is based on published research that looked at almost 700,000 patients treated at 1,154 hospitals nationwide between 2002 and 2006. The results are surprising, considering
"...insurance status isn't supposed to be a factor for trauma patients. The Emergency Medical Treatment and Active Labor Act, passed by Congress in 1986, guarantees that people brought to emergency rooms get all necessary treatment no matter what kind of insurance they do -- or don't -- have."
Researchers and trauma staff alike are taken aback by the findings, and are searching for possible reasons. We do know that uninsured patients wait longer to see doctors in the E/R and they are given fewer services such as MRIs than insured patients. We don't know if they're in worse physical shape by the time they present as trauma victims, thus making them less likely to recover, or if they are more "passive" in managing their care because they don't interact with the medical system as often. Is there a correlation between type of injury and insured status? Are the hospitals more likely to treat the uninsured also more likely to lack resources needed to successfully treat them?
Sounds like there's a lot more data mining to do, and yet more proof - as if we needed it - that we need healthcare reform YESTERDAY. It's a matter of life or death.
(Photo by Paul Keleher)
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Comments (3)
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Author
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Leigh is a PhD candidate in urban planning at MIT, and a consultant on U.S. Gulf Coast recovery. She sits on the Board of the Allston-Brighton Community Development Corporation in Boston, and has worked with non-profits, foundations and local governments on policies and programs aimed at reducing urban poverty and inequality.
This article is too funny...first of all there is no data on the injurity severity score, the mechanism invovled or their definition of "trauma"! All this article does is get a shock and awe reaction! So sad that people will read this and believe it! oh and 76% of statistics are false.....
Posted by mike martin on 11/24/2009 @ 11:14AM PT
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Hey Mike, nice to know you're too lazy to click through to read the original news story, and to click through that to read the published study. See if you can muster up the energy to read this excerpt:
"The types of injuries may differ too, Zwemer said. Gunshot and stabbing victims -- frequently younger people involved in crime -- were much more likely to die from their wounds than other trauma patients tracked in the study. These people are generally uninsured, but the type of injury -- not insurance status -- is the reason for their higher fatality rates, he said."
Sounds like the researchers won't turn to you for additional help sorting through this complex outcome.
Thanks for stopping by.
Posted by Leigh Graham on 11/24/2009 @ 11:48AM PT
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I tend to agree with Leigh and the article that it's hard to know what's causing what here - I suspect the real indictment here is aimed at hospitals and emergency rooms, which have been treated fairly uncritically in the midst of the health reform discussions (the "uninsured turn up in ERs" being a discussion about overcrowded results, not particularly about whether the care is good or not). ER docs and nurses work very hard and face tremendous pressures... but this data does suggest that there's reason to ask if ERs are, in fact, the best solution we've got (or are we putting, say, too much faith in high pressure, emergency situations to deliver miracles on cue?). Whether insurance or lack thereof is at the root here is hard to tell... but I think the data tends to underline the overall complexity of what we're discussing: insurance companies have been trying to cover the young, the healthy, the well employed and the well educated. What follows from that is... who they're not covering: poorer, not employed, less educated... and that they might have other issues (like, say those kids with the gunshot wounds). We are trying very hard to solve for one piece of what I think is really a far more complicated puzzle, and one result - which Massachusetts already shows - is that once the uninsured get insured, they will turn out to be sick. And in need of care that can be expensive. And that unpacks a lot of other problems.
As before, I'd feel better about saying "insurance reform is crucial" if I thought that was the solution (and that the bills in Congress actually dealt well with that, even). But I'd be happier, really, if healthcare reform were a more comprehensive discussion, one that took in a more hoistic approach to asking who winds up in an ER with major traums, why, and how there's more to solve for than just the care they're about to get... which may not help them. Without thinking bigger, we're left clutching at data points and theorizing and, well, guessing. That doesn't seem like a good answer for anything.
Posted by NYC Weboy on 11/25/2009 @ 12:29PM PT
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