High Death Rate of the Uninsured in Hospitals Cited

The death rate among hospital patients who lack medical insurance is triple that of similar patients who have coverage, a report says, adding to evidence that ability to pay affects treatment.

“The fact that we did find such striking trends in in-hospital mortality rates is troubling, is very troubling,” said Jack Hadley, who led a team that analyzed the hospital records of nearly 600,000 patients.

But not all the variability in death rates is necessarily related to the quality of care received, said Hadley, co-director of the Center for Health Policy Studies at Georgetown University School of Medicine.

“It could be that people with private insurance are being discharged to a nursing home or a hospice” to die, he said in a telephone interview from Washington, D. C. “Without insurance, they may stay in the hospital.”

Also, he said, the uninsured people perhaps “didn’t get the care they needed before they came in, or they waited too long.”

The findings, he said, “point to the possibility of there being a real health consequence of not having health insurance.”

Uninsured patients were also 29% to 75% less likely to undergo any of five highly discretionary--and costly--medical procedures, the study found.