|Insurance Affects ICU Survival Rate In U.S.: Study|
|Intensive care patients who did not have health insurance were 21 percent more likely to die than insured patients, U.S. researchers reported on Monday.Their study of intensive care units or ICUs in Pennsylvania adds to arguments that a lack of health insurance can be deadly. Health insurance reform legislation signed into law last March aims to sharply reduce the numbers of Americans — currently around 15 percent of the population — who do not have health insurance.
“Our findings suggest that ICU patients without insurance have a higher risk of death and receive less intense treatment in the ICU,” Dr. Sarah Lyon of the University of Pennsylvania, who led the study, said in a statement.
“Expanding and standardizing health care coverage through health care reform may improve outcomes in critically ill patients,” she added.
Her team looked at data from all 166,995 adult patients under age 65 admitted to Pennsylvania ICUs from 2005 to 2006.
About two-thirds had private insurance, 28 percent had Medicaid, the state-federal health insurance plan for the poor, and 3.8 percent had no insurance.
The uninsured patients were 21 percent more likely to die within 30 days than patients with private insurance, the researchers told a meeting in New Orleans of the American Thoracic Society.
“We still do not understand all the reasons for differences in survival between the insured and uninsured,” Lyon said.
“Critically ill patients without insurance may arrive to the hospital in more advanced stages of illness, perhaps in ways we could not control for in our study. Patients without insurance may also have different preferences for intensity of care at the end of life, and may not wish to be kept alive on life support as long as patients with insurance.”
But there could be another reason, she said.
“Another, more concerning explanation is that physicians and hospitals treat patients without insurance differently than those with insurance. More work is needed before we can say with certainty that treatment biases caused these results.”
The uninsured patients did not go to poorer-quality hospitals, she said. The disparities persisted across even the same hospitals.
About 46.3 million people in the United States lacked coverage in 2008, the U.S. Census Bureau reports, up from 45.7 million in 2007. About 30 to 32 million people are expected to gain health insurance under the new legislation.
In September, Harvard Medical School researchers reported that nearly 45,000 people die in the United States each year because they lack health insurance.