Interesting Correlation Regarding The Uninsured

My thought is that street crime and resulting more-severe trauma correlates well with low income which also correlates well with lack of health insurance. But it's an interesting observation nonetheless:

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 Tuesday.

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 to be admitted to specialty hospitals for procedures such as heart bypass surgery, for example. Overall, about 18,000 deaths each year have been traced to a lack of health insurance.

...The risk of death was 56% higher for patients covered by Medicare, perhaps because the government health plan includes many people with long-term disabilities, said Dr. Heather Rosen, who led the study while she was a research fellow at Harvard Medical School.

However, the risk of death was 80% higher for patients without any insurance, according to the report.

...Rosen, now a surgical resident at USC's Keck School of Medicine, said the group expected to find at least some disparity based on insurance status. But she said the group was surprised at the magnitude of the gap.

...The researchers offered several possible explanations for the findings. 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.

Patients without insurance may have higher rates of untreated underlying conditions that make it harder to recover from trauma injuries, the researchers said. They also may be more passive with doctors and nurses since they don't interact with them as often. All of these factors could influence whether a trauma patient is able to recover from his or her injuries.

But the link could also be coincidental, the authors acknowledged. Perhaps the hospitals that have fewer resources at their disposal also happen to see the most uninsured patients, they said.

The types of injuries may differ too, Zwemer said. Gunshot and stabbing victims were much more likely to die from their wounds than other trauma patients tracked in the study. These people are generally uninsured, but the type of injury -- not insurance status -- is the reason for their higher fatality rates, he said.