Uninsured children admitted to hospitals are twice as likely to die as insured children

Children who lack health insurance are twice as likely to die from their injuries after being hospitalized as children who are insured, according to a new report released by Families USA, USA Today reports. For the report, researchers led by J. Mick Tilford of the University of Arkansas for Medical Sciences analyzed government data from 2000 and 2003.

The researchers examined the records of 25,000 uninsured children with general injuries and 6,500 with traumatic brain injuries and compared them with the records of insured children, adjusting to control for age, severity of injury and other case aspects. Researchers noted that they could not control for some factors, according to USA Today. The study found that the uninsured children had 327 "excess deaths" over two years. Researchers also reported the following findings:

• Uninsured children admitted to hospitals with general injuries were twice as likely to die and 44% less likely to receive rehabilitative services than insured children;
• Uninsured children with traumatic brain injuries were 32% less likely to receive intracranial pressure monitoring and were discharged after an average of five days, compared with eight days for insured children;
• Uninsured children with appendicitis were 18% less likely to receive a more costly laparoscopic appendectomy; and
• Uninsured children with middle ear infections were 57% less likely to undergo a surgical procedure to insert ear tubes.

Tilford said, "It's a pattern," adding, "You look at stuff by insurance status -- boy, you find differences." Families USA Executive Director Ron Pollack said, "The clear implication ... is that when kids get sick or hurt, insurance matters," adding, "As is true throughout our health care system, children without health insurance receive less and inferior care." Families USA this week sent the report to a number of congressional committees that are considering health care issues, including the reauthorization of SCHIP.

Reaction
The Federation of American Hospitals and the American Hospital Association disputed the methodology used in the study, saying that researchers failed to take into account the types of hospitals, clinical decisions and details on individual patients. They also noted that the sample size was small and that the study was not peer-reviewed, according to USA Today. FAH President Chip Kahn said, "I consider the study irresponsible because it is not sufficiently thorough," adding, "I'm worried that this will get people to focus on hospitals, rather than the kids." AHA spokesperson Molly Collins Offner said that hospitals are "the last resort of care," adding, "They're clearly covering patients who need care and can't afford to pay it" (Wolf, USA Today, 3/2).

The report is available online. Note: You must have Adobe Acrobat Reader to view the report.

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.