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Uninsured Face Worse Outcomes After Diverticulitis
Date:12/15/2008

Delaying care, they may present with more complications, experts say

MONDAY, Dec. 15 (HealthDay News) -- Patients lacking adequate health insurance are more like to fare poorly after a diagnosis of the painful and sometimes deadly intestinal condition known as diverticulitis, a new study finds.

In fact, insurance status may explain long-observed disparities in outcomes between black and white patients with the ailment, the researchers say.

"Uninsured patients are more likely to present in a more complicated status," meaning that they have delayed seeking treatment, said David C. Chang, an assistant professor of surgery at Johns Hopkins University and senior author of a report in the December issue of the Archives of Surgery.

In fact, he said, "Uninsured patients are 164 percent more likely to die after [diverticulitis] surgery than insured patients."

Diverticulitis involves the inflammation and infection of small pockets that form in the intestine. Complications of the condition include bowel obstruction, hemorrhage or perforation of the intestine. More than 200,000 Americans are hospitalized each year for diverticulitis, which becomes more common as people age. It accounts for more than $300 million in U.S. health costs each year.

Diverticulitis is also one of many conditions for which poorer results have been reported for blacks than for whites.

However, the Johns Hopkins analysis of nationwide data found that "insurance is a bigger issue than race," said Chang.

Chang was a member of a group led by Dr. Anne O. Lidor, an assistant professor of surgery at Hopkins. Her team studied information on more than 45,500 people treated for diverticulitis between 1999 and 2003.

Race was not associated with the type of surgical treatment received for diverticulitis, the researchers reported.

"In contrast, insurance status did correlate with the type of t
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