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Lack of Insurance Puts Kids in Peril

Health Insurance May Have Prevented Thousands of Child Deaths, Researchers Estimate
By
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 30, 2009 -- Nearly 17,000 deaths of hospitalized children might have been prevented by having insurance over a span of 18 years, researchers from Johns Hopkins in Baltimore estimate in a new study.

Researcher Fizan Abdullah, MD, PhD, assistant professor of surgery at Johns Hopkins School of Medicine, says the large study shows that “if you are a child without insurance, if you’re seriously ill and end up in the hospital, you are 60% more likely to die than the sick child in the next room who has insurance.” The research is being published in the Oct. 30 Journal of Public Health.

Abdullah and colleagues analyzed 23 million pediatric inpatient hospital records from 37 states covering the years 1988 to 2005, comparing the risk of death of children with insurance to those without it.

After taking into account factors such as age and hospital region, hospitalized uninsured children in the study were 60% more likely to die than those with insurance, the researchers write.

The uninsured appeared to have an increased risk of dying regardless of their medical conditions, the researchers write. The findings do not count children who died without ever being hospitalized or after hospital discharge, which means the death toll of non-insured kids could well have been higher.

Although the research can’t establish a cause-and-effect relationship between lack of health insurance and death, the authors write that the findings are in line with similar associations seen in adult patients.

In a news release, David Chang, PhD, MPH, MBA, an assistant professor at the Johns Hopkins School of Medicine and co-author of the study, says it can’t be asserted with “absolute certainty” that the estimate of nearly 17,000 children who died over the nearly two-decade span might have lived, had they had health insurance, but he adds that the point of the study is “that a substantial number of children may be saved by health insurance.”

However, Chang says in the news release that “from a scientific perspective we are confident in our findings that thousands of children likely did die because they lacked insurance or because of factors directly related to lack of insurance.”

The researchers say policymakers and the public should take note of the findings because more than 7 million children in the United States are uninsured as the nation struggles with health care reform.

“Thousands of children die needlessly each year because we lack a health system that provides them health insurance,” says Peter Pronovost, MD, PhD, co-author and director of critical care medicine at Hopkins who also heads the university’s Center for Innovations in Quality Patient Care. “In a country as wealthy as ours, the need to provide health insurance to the millions of children who lack it is a moral, not an economic issue.”

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