Thanks to Liberal Oasis for this story.
In a 2008 study published in the Archives of Surgery, Race and Insurance Status as Risk Factors for Trauma Mortality (pdf), looking at around 400,000 trauma (excluding burns) patients between the ages of 17 and 64 who were alive when they reached the hospital, and sorting on race and insurance status, the study’s authors found a couple of things.
First, non-hispanic Caucasians had a better chance of survival than Hispanics and African-Americans. Second, insured patients had a better chance of survival than uninsured patients. But, surprisingly, insurance status was a better predictor of outcome than race. Insured African-Americans and insured Hispanics had lower mortality rates than uninsured non-hispanic Caucasians. Overall, the mortality rate in the uninsured was twice the mortality rate among the insured.
The authors of the study comment:
Lack of medical insurance is most often associated with worse baseline health status, with increased and poorly recognized comorbidities. It is known that preexisting medical conditions are associated with poor outcomes after trauma, suggesting that an uninsured patient would do worse after traumatic injury. This may partially explain our finding that the adjusted odds of death substantially increased for all uninsured patients, even when we controlled for injury severity and other factors known to affect trauma outcomes.They also say:
This work suggests that quality of care issues for trauma patients are worthy of investigation. In a statewide study of trauma patients in Massachusetts, uninsured patients were less likely to receive an operation, less likely to receive rehabilitative therapies (in-house physical therapy), and more likely to die in the hospital.The authors caution:
Our study likely provokes more questions than it provides answers for. It may be that insurance status is a surrogate for other factors that affect mortality in a critically injured patient (eg, health education, awareness and management of comorbidities, substance abuse, and risk-taking behaviors). In brief, insurance represents more than just the ability to pay a bill.Yet still they conclude:
These data suggest that addressing disparities in health insurance status would have a significant effect on outcomes of traumatic injuries for African American, Hispanic, and white patients.
A couple of concepts that you should understand before reading the original article: