BUFFALO, N.Y. -- Trauma patients without insurance are more likely to die of their injuries from auto accidents and gunshot wounds than privately insured patients with similar injuries, according to findings of an analysis of 193,804 patients from 649 facilities conducted by University Buffalo emergency medicine physicians.
In addition, the authors found that Medicaid patients who were injured in motor vehicle accidents had a lower death rate than those with private insurance, indicating that factors other than the level of financial remuneration for medical services are influencing trauma outcomes.
Patients covered by any of the insurance plans studied -- Medicaid, Medicare, private and managed care organizations such as HMOs -- had better mortality rates for all injuries than persons without insurance, the analysis showed.
Results of the study were presented June 4 at the 2010 Society for Academic Emergency Medicine Annual Meeting in Phoenix, Ariz.
Dietrich Jehle, MD, UB professor of emergency medicine and first author on the study, says these findings suggest that the causes of this difference are many and probably are not based just on quality of care.
"Generally we don't know a trauma patient's insurance status when we treat them initially in the emergency department, which makes us ask if there are differences in these populations other than the delivery of care," says Jehle. "This finding was a little surprising.
"Both race and insurance status are independent predictors of mortality rates for trauma outcomes, and of the two, insurance status, specifically lack of coverage, is the most significant," he continues. "This is not unexpected, since uninsured adult patients in general have a 25 percent greater morality rate than insured adults for all medical conditions."
Lack of insurance could influence mortality in a number of ways, notes Jehle. With no way to pay for care, persons may
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