Trauma Deadlier for Kids Without Insurance

TUESDAY Nov. 3, 2009 -- Uninsured children in the United States are three times more likely to die from trauma injuries than children with private insurance, according to a new study.

Children with public insurance, such as Medicaid or the State Children's Health Insurance Program, are about twice as likely to die as those with private insurance, the study found.

"We have this idea that everyone is treated equally, yet the mortality rate after trauma among uninsured children is much higher when compared to children with commercial insurance," Dr. Heather Rosen, a research fellow in plastic surgery at Children's Hospital Boston and Harvard Medical School and the study's lead researcher, said in a news release from the hospital.

The findings, published in the October issue of the Journal of Pediatric Surgery, stemmed from an analysis of National Trauma Data Bank information on 174,921 trauma patients aged 17 and younger.

The researchers suggested several possible reasons for the disparity they found:

  • Trauma patients with no insurance or public insurance might be transferred from one hospital to another, causing a delay in treatment.
  • Uninsured patients might be given fewer medical tests, leading to inadequate diagnoses or missed injuries.
  • If uninsured patients don't speak English, if it's not their native language, or if their education level is lower overall, they might have trouble talking to health-care providers about their medical history and quality of care after they were injured.

"This study suggests that there may be a direct effect of possessing insurance," Rosen said. "We need to work harder to get to the point where every person has access to health care in this country."

She noted that the federal Emergency Medical Treatment and Active Labor Act (EMTALA) requires all hospitals to treat patients until they're medically stable, regardless of insurance status.

"This paper provokes more questions than it answers," she said. "Should we be more vigilant about investigating whether EMTALA laws are being violated? Is this happening more often than we care to admit?"

More information

The U.S. Centers for Disease Control and Prevention offers tips for protecting children from injuries.

Posted: November 2009


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