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ATS systematic review: Critical care outcomes tied to insurance status
Date:4/28/2010

Among the general U.S. population, people who are uninsured are about half as likely to receive critical care services as those with insurance, according to systematic review of the literature by the American Thoracic Society's Health Disparities Group. They also found that once admitted to the hospital intensive care unit, uninsured patients are less likely to have invasive procedures or pulmonary artery catheterizations and more likely to have life support withdrawn.

"Patients in the United States who do not have health insurance and become critically ill receive fewer critical care services and may experience worse clinical outcomes," said J. Randall Curtis, M.D., M.P.H., president of the ATS, and an investigator for the review. "Improving preexisting health care coverage may be one mechanism to reduce such disparities."

The researchers reviewed more than 5,500 citations on critical care and insurance status, ultimately identifying 29 observational studies that described the admissions and outcomes for critically ill patients with and without insurance.

The results were published as an official systematic review in the May 1 issue of the American Journal of Respiratory and Critical Care Medicine.

Currently, one-third of the population under the age of 65 is uninsured for a portion of any given year, and the costs of critical care is approaching one percent of the U.S. gross domestic product.

In addition to reduced services and greater discharge delays among uninsured, the review found that while uninsured patients were slightly more likely to be admitted overall, the difference was not statistically significant, those with traumatic injuries were 63 percent as likely to be admitted as those with insurance.

"The finding that the uninsured were more likely to be admitted to the ICU after arriving at the hospital could occur if the uninsured delayed going to a hospital until experiencing a more adv
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Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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