0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

More Bad News for the Uninsured

Ellen Meara, PhD
Arch Surg. 2010;145(6):604. doi:10.1001/archsurg.2010.100.
Text Size: A A A
Published online

Extract

The recent article by Rosen and colleagues1 presents a sobering reminder that insurance does matter for health, precisely in situations in which the health of patients is most in jeopardy, such as trauma. Unfortunately, as is so often the case when different disciplines fail to interact, the authors missed an opportunity to strengthen support for their findings. They overlooked a carefully designed 2005 study of automobile crash victims in which at least 1 other fatality occurred.2 In the 2005 study, Doyle used detailed data on the nature of automobile crashes linked to hospital discharge data and mortality status for automobile crashes in Wisconsin. Doyle demonstrated that mortality rates were 1.5 percentage points higher for uninsured accident victims compared with insured accident victims, a 40% increase over the mean mortality rate of 3.8%. The uninsured victims also received 20% less medical care (measured by length of stay and spending) than insured comparisons. The mortality estimate in the Doyle study is nearly identical to that in the Rosen et al study (Doyle's estimate would yield an odds ratio of 1.4, the same found in the Rosen et al study). The clinical richness of the current study nicely complements the careful effort to remove confounding factors in the prior study. Together, these and other evidence referenced in the article argue more strongly than ever for the value of health insurance coverage, not simply for financial protection, but to improve health.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

June 1, 2010
Heather Rosen, MD, MPH; Fady Saleh, MD, MPH; Stuart R. Lipsitz, ScD; Selwyn O. Rogers, Jr; Atul A. Gawande, MD, MPH
Arch Surg. 2010;145(6):604-605. doi:10.1001/archsurg.2010.101.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
Jobs
brightcove.createExperiences();