COMPARISON OF UNINSURED AND PRIVATELY INSURED HOSPITAL PATIENTS - CONDITION ON ADMISSION, RESOURCE USE, AND OUTCOME
COMPARISON OF UNINSURED AND PRIVATELY INSURED HOSPITAL PATIENTS - CONDITION ON ADMISSION, RESOURCE USE, AND OUTCOME
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DOI：
10.1001/jama.265.3.374
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发表时间：
1991-01-16
影响因子：
120.7
通讯作者：
FEDER, J
中科院分区：
文献类型：
--
作者：
HADLEY, J;STEINBERG, EP;FEDER, J
为了调查保险状况与入院条件、资源利用和院内死亡率之间的关联，我们分析了 1987 年全国医院样本中 592 598 名住院患者的出院摘要。 在 16 个年龄、性别、种族特定队列中的 13 个中，未投保的人入院时的院内死亡风险比有私人保险的人高 44% 至 124%。控制这一差异后，16 个队列中的 11 个队列中，未参保患者的实际院内死亡率高出 1.2 至 3.2 倍。未投保的人接受五次高成本或高度谨慎的手术中每一次的可能性也降低了 29% 至 75%，并且在七种不同的内窥镜手术中的五次中进行的活检的组织病理学报告中获得正常结果的可能性也降低了 50%。 我们的结果表明，保险状况与医院护理的广泛方面相关。
To investigate the association between insurance status and condition on admission, resource use, and in-hospital mortality, we analyzed discharge abstracts for 592 598 patients hospitalized in 1987 in a national sample of hospitals. In 13 of 16 age-sex-race-specific cohorts, the uninsured had a 44% to 124% higher risk of in-hospital mortality at the time of admission than did the privately insured. After controlling for this difference, the actual in-hospital death rate was 1.2 to 3.2 times higher among uninsured patients in 11 of 16 cohorts. The uninsured also were 29% to 75% less likely to undergo each of five high-cost or high-discretion procedures and 50% less likely to have normal results on tissue pathology reports for biopsies performed during five of seven different endoscopic procedures. Our results suggest that insurance status is associated with a broad spectrum of aspects of hospital care.