A multivariable analysis showed no significant differences in the likelihood of perforation when comparing Caucasian, African-American, Hispanic and Asian patients. However, as compared with patients with private insurance, uninsured (OR=1.18, 95% CI [1.07, 1.30], p=0.0005), Medicaid (OR=1.22, 95% CI [1.12, 1.33], p< p.0001) and Medicare patients (OR 1.14, 95% CI [1.03, 1.25], p=0.01) were all more likely to have perforated.
Dr. Pieracci said this effect may be due to several factors. First, because both uninsured and publicly insured patients are less likely to have a usual source of health care, difficulty in consulting a health care provider may delay hospitalization. In addition, longer waiting times once care has been sought may contribute to delayed treatment. Perhaps most importantly, said Dr. Pieracci, uninsured patients may delay seeking care for fear of financial repercussions.
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