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  Vol. 265 No. 3, January 16, 1991 TABLE OF CONTENTS
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Comparison of Uninsured and Privately Insured Hospital Patients

Condition on Admission, Resource Use, and Outcome

Jack Hadley, PhD; Earl P. Steinberg, MD, MPP; Judith Feder, PhD

JAMA. 1991;265(3):374-379.


Abstract

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.

(JAMA. 1991;265:374-379)



Author Affiliations

From the Center for Health Policy Studies, Georgetown University School of Medicine, Washington, DC (Drs Hadley and Feder), and The Johns Hopkins Program for Medical Technology and Practice Assessment, The Johns Hopkins University, Baltimore, Md (Dr Steinberg).


Footnotes

Reprint requests to Center for Health Policy Studies, 2233 Wisconsin Ave NW, Suite 525, Washington, DC 20007 (Dr Hadley).



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