To assess the effect of insurance status on the probability of admission and subsequent health status of patients presenting to emergency departments.
We performed a prospective cohort study of patients with common medical problems at five urban, academic hospital emergency departments in Boston and Cambridge, Massachusetts.
The outcome measure for the study was admission to the hospital from the emergency department and functional health status at baseline and follow-up.
During a 1-month period, 2,562 patients younger than 65 years of age presented with either abdominal pain (52%), chest pain (19%) or shortness of breath (29%). Of the 1,368 patients eligible for questionnaire, 1,162 (85%) completed baseline questionnaires, and of these, 964 (83%) completed telephone follow-up interviews 10 days later.
Fifteen percent of patients were uninsured and 34% were admitted to the hospital from the emergency department.
Uninsured patients were significantly less likely than insured patients to be admitted, both when adjusting for urgency, chief complaint, age, gender and hospital (odds ratio=0.5,95% confidence interval 0.3 to 0.7), and when additionally adjusting for comorbid conditions, lack of a regular physician, income, employment status, education and race (odds ratio=0.4,95% confidence interval 0.2 to 0.8). (...)
Mots-clés Pascal : Etats Unis, Amérique du Nord, Amérique, Homme, Hospitalisation, Soin santé primaire, Assurance maladie, Economie santé, Admission hôpital, Service urgence, Qualité, Soin
Mots-clés Pascal anglais : United States, North America, America, Human, Hospitalization, Primary health care, Health insurance, Health economy, Hospital admission, Emergency department, Quality, Care
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0070314
Code Inist : 002B30A11. Création : 31/05/1999.