Compare health outcomes for people with private insurance, Medicaid recipients, and people without insurance. Give examples.

Expert Answers
randroid eNotes educator| Certified Educator

To answer this question, I consulted a 2015 study called "Association of Insurance Status with Health Outcomes Following Traumatic Injury: Statewide Multicenter Analysis" by Chikani. This study looked at the relationship between the health insurance trauma patients in Arizona used and their health outcome. They found that there was indeed a correlation between insurance and health outcome, and that people without insurance (or self-pay patients) were as much as two or three times as likely to die as a result of their injury than patients with private insurance.

Insured patients consisted of 86.7% of the study population. These patients were found to be the most likely to survive, both in measures of overall mortality and in-hospital mortality. They were also much more likely to discharge to a rehab than self-pay patients, while only slightly more likely to discharge to a rehab than Medicaid patients. It's interesting to note that these patients were also more likely to extend their stay in the hospital, with a median of a 2-day stay. It's possible that this is because their insurance helped carry the cost of a longer visit. This could be one of the factors that help contribute toward successful recovery.

Of the study population, 38.8% used Medicaid. They had a higher overall mortality rate compared to patients with private insurance. After excluding patients who died on arrival to the emergency room, Medicaid patients still had higher in-hospital mortality rates compared to private insurance users. The Medicaid users had similar but slightly smaller rates of discharge to rehab as private insurance users. 

The study consisted of 13.3% uninsured patients. Self-pay patients were more likely to have a less severe injury compared to the other insurance groups studied. Even so, they were two to three times as likely to die than patients with private insurance. This could be since more of them suffered from penetrating trauma (a more high-risk kind of injury than blunt trauma) than other insurance groups. They had significantly shorter hospital stays than individuals with private insurance, with a median of a one-day stay. These patients also had the lowest rate of discharge to rehab to recover. They had higher in-hospital mortality rates as well. Self-pay status was also significantly connected with death related to accidental injuries and assaults.