No Health Insurance Is Deadly, Costly

Background: Surgeons perform elective surgery to avoid subsequent complications. Uninsured patients are more likely to defer elective surgery. What are the consequences for patients and for public policy? Objective: To determine how insurance status affects the likelihood of unplanned surgery for access-sensitive conditions. Design: Cross-sectional cohort study. Methods: 8 state inpatient databases (Arizona, Colorado, Florida, Kentucky, Maryland, North Carolina, Washington, and Wisconsin) provided data on patients aged Results: 146,609 patients, 50.0% male, 5.2% AAA repair, 26.5% ventral hernia repair, and 68.3% colectomy for colon cancer formed the cohort. Of all, 5.5% were uninsured, 19.6% had Medicaid, and 70.9% were privately insured. Overall, 39.3% of surgeries were unplanned. For colectomy, unplanned surgery rates were 33.1% for privately insured, 51.5% for Medicaid, and 72.6% for the uninsured. Uninsured patients, compared to privately insured patients, suffered higher rates o more...