Private Insurance Linked to Lower Hospital Mortality

Finding noted in adults with acute MI, stroke, pneumonia versus uninsured, Medicaid recipients
By Eric Metcalf
HealthDay Reporter

FRIDAY, June 11 (HealthDay News) -- Patients with private insurance who are hospitalized for acute myocardial infarction (AMI), stroke or pneumonia have significantly lower in-hospital mortality than patients who are uninsured or have Medicaid, according to research published online June 10 in the Journal of Hospital Medicine.

Omar Hasan, of the Brigham and Women's Hospital in Boston, and colleagues analyzed data from the 2005 Nationwide Inpatient Sample on 154,381 discharges of adults aged 18 to 64 who had a principal diagnosis of either AMI, stroke or pneumonia.

The researchers found that the uninsured patients with AMI and stroke had significantly higher in-hospital mortality compared to the privately insured (adjusted odds ratios, 1.52 and 1.49, respectively). For pneumonia patients, those on Medicaid had a higher risk of in-hospital mortality than those with private insurance (adjusted odds ratio, 1.21). After excluding those who died during hospitalization, length of stay for all three conditions was longer for those with Medicaid.

"Significant insurance-related differences in mortality exist for two of the leading causes of non-cancer inpatient deaths among working-age Americans. Further studies are needed to determine whether provider sensitivity to insurance status or unmeasured sociodemographic and clinical prognostic factors are responsible for these disparities. Policy makers, hospital administrators, and physicians should be cognizant of these disparities and consider policies to address potential insurance-related gaps in the quality of inpatient care," the authors conclude.

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