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Uninsured Americans have 50 percent higher odds of dying in hospital from heart attack or stroke
Date:6/9/2010

An analysis of over 150,000 hospital discharges has revealed that there are significant insurance related differences in hospital mortality, length of stay, and costs among working-age Americans (age 18-64 years) hospitalized for acute myocardial infarction (AMI), stroke, or pneumonia. These three conditions are among the leading causes of non-cancer in-patient deaths in patients under 65 years old. The analysis is published today in the Journal of Hospital Medicine.

Compared with the privately insured, hospital mortality among AMI and stroke patients was significantly higher for the uninsured, 52% and 49% higher odds, respectively, and 21% higher among Medicaid recipients with pneumonia. Length of stay was significantly longer for Medicaid recipients for all three conditions while hospital costs were higher for Medicaid recipients for stroke and pneumonia, but not AMI. These disparities in hospital care were present even after accounting for differences in baseline health, socioeconomic status, and disease severity.

With about one in five working-age Americans currently uninsured and a large number relying on Medicaid, adequate access to quality health care services is becoming increasingly difficult. Although numerous studies have focused on insurance related disparities in the outpatient setting, few nationally representative studies have examined such disparities among hospitalized patients. The current study is a retrospective database analysis of 154,381 adult discharges with a principal diagnosis of AMI, 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 of Harvard Medical Scho
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Contact: Jennifer Beal
healthnews@wiley.com
44-124-377-0633
Wiley-Blackwell
Source:Eurekalert

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