Study: Uninsured kids fare worse at hospitals

By Richard Wolf, USA TODAY

WASHINGTON — Hospitalized children who lack health insurance are twice as likely to die from their injuries as those with insurance, a new study reports.

Uninsured children also are less likely to get expensive treatment or rehabilitation and are discharged earlier, says the study by the health care advocacy group Families USA.

The report was sent this week to congressional committees that are considering ways to help some of the nation's 47 million uninsured people, including 9 million children, get coverage. A federal-state program created in 1997 that has insured more than 6 million children is up for renewal this year.

"The clear implication … is that when kids get sick or hurt, insurance matters," said Ron Pollack, executive director of Families USA. "As is true throughout our health care system, children without health insurance receive less and inferior care."

Representatives of two major hospital associations disputed the study's methodology. They said it failed to take into consideration the types of hospitals involved, clinical decisions made and details on each patient's condition. They said the sample size was small and the report was not peer-reviewed.

"I consider the study irresponsible because it is not sufficiently thorough," said Chip Kahn, president of the Federation of American Hospitals. "I'm worried that this will get people to focus on hospitals, rather than the kids."

The Families USA study comes from an analysis of government data for 2000 and 2003. The data were adjusted to control for age, health, severity of injury and other factors. Still, researchers said some factors could not be controlled.

J. Mick Tilford, associate professor at the University of Arkansas for Medical Sciences, said the data he studied for the Families USA report included 25,000 uninsured children with general injuries and 6,500 with traumatic brain injuries. Compared with insured children, he said, the uninsured had 327 "excess deaths" over two years.

Hospitals and their emergency rooms are often the only option for uninsured children and adults. They are supposed to treat patients regardless of ability to pay. Some costs eventually are paid by the uninsured, and some are passed on to other patients. In 2004, more than $25 billion in uncompensated care was borne by hospitals, according to the Kaiser Commission on Medicaid and the Uninsured.

Hospitals are "the last resort of care," said Molly Collins Offner of the American Hospital Association, which also disputed the study. "They're clearly covering patients who need care and can't afford to pay it."

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