November 17, 2009 in Nation/World

Study finds lack of insurance has role in trauma deaths

Karen Kaplan Los Angeles Times

Equal treatment

The Emergency Medical Treatment and Active Labor Act, passed by Congress in 1986, guarantees that people brought to emergency rooms get all necessary treatment no matter what kind of insurance they do – or don’t – have.

Patients who lack health insurance are more likely to die from car accidents and other traumatic injuries than people who belong to a health plan – even though emergency rooms are required to care for all comers regardless of ability to pay, according to a study to be published today.

An analysis of 687,091 patients who visited trauma centers nationwide between 2002 and 2006 found that the odds of dying following an accidental injury 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 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 equal risks of death from traumatic injuries when the patients’ age, sex, race and severity of injury were taken into account.

However, the risk of death was 80 percent higher for patients without insurance, the report said.

The researchers offered several possible explanations. Despite the federal law, uninsured patients often wait longer to see doctors in emergency rooms and sometimes visit ERs at several hospitals before finding one that will treat them.

Other studies show that once they’re admitted, uninsured patients receive fewer services such as CT and MRI scans and are less likely to be transferred to a rehabilitation facility.

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