The Uninsured Are Twice as Likely to Die in the ER From a Traumatic Injury Than the Insured

Among those 45,000 deaths a years among the uninsured are those dying in emergency rooms as the result of traumatic injuries, and the uninsured are much more likely to die than those with insurance.


An analysis of 687,091 patients who visited trauma centers nationwide from 2002 to 2006 found that the odds of dying from injuries were almost twice as high for the uninsured than for patients with private insurance, researchers reported in Archives of Surgery.

Trauma physicians said they were surprised by the findings, even though a slew of studies had previously documented the ill effects of going without health coverage. Uninsured patients are less likely to be screened for certain cancers or to be admitted to specialty hospitals for procedures such as heart bypass surgery. Overall, about 18,000 deaths each year have been traced to a lack of health insurance....

The research team from Harvard University and Brigham and Women's Hospital in Boston used information from 1,154 U.S. hospitals that contribute to the National Trauma Data Bank. The team found that patients enrolled in commercial health plans, health maintenance organizations or Medicaid had an equal risk of death from traumatic injuries when the patients' age, gender, race and severity of injury were taken into account.

The risk of death was 56% higher for patients covered by Medicare, perhaps because the government health plan includes many people with long-term disabilities, said Dr. Heather Rosen, who led the study while she was a research fellow at Harvard Medical School.

The risk of death was 80% higher for patients without any insurance, the report said.

The reason for this much higher risk of death isn't immediately clear. The researchers point out that, while federal law requires that emergency rooms provide care, the uninsured often have longer waits in the ER, and sometimes have to go to various ERs to find one that will treat them. They are also likely to receive fewer services, especially expensive ones like MRI scans. They also are likely to have more untreated underlying condidtions that compromise their overall health. Additionally, the demographics of the uninsured and traumatic injuries is a factor; "gunshot and stabbing victims -- frequently younger people involved in crime" are more likely to die and more likely to be uninsured than other trauma patients.

Bottom line, being uninsured is potentially deadly. The moral and financial costs to the country are unacceptable, and any member of Congress who obstructs this effort to reform the system will carry the responsibilty of those deaths.

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