SCIENCE / MEDICINE : Indigent Patient Costs Cited

Poor patients tend to be hospitalized longer than more affluent patients, and their more costly care could give hospitals an incentive to turn away indigent Medicare patients, according to Harvard researchers.

A study involving 402 patients treated at the Brigham and Women’s Hospital in Boston from 1981 to 1985 found hospital stays were significantly longer, and therefore more costly, for patients from low socioeconomic backgrounds.

“Our results suggest that for at least some conditions, hospital care for poor patients entails longer stays and probably requires the use of more resources,” the researchers said in the New England Journal of Medicine.

The findings add support to criticism of the federal government’s Medicare program, which reimburses hospitals at a flat rate based on the type of illness a patient has, said Dr. Arnold M. Epstein of the Harvard School of Public Health, who headed the study.

Since the study shows that poor patients tend to require more costly care, the findings suggest the flat-fee reimbursement policy gives hospitals an incentive to avoid treating poor patients, he said.