Increased Risk of Death among Uninsured Neonates
Article first published online: 13 FEB 2013
© Health Research and Educational Trust
Health Services Research
Volume 48, Issue 4, pages 1232–1255, August 2013
How to Cite
Morriss, F. H. (2013), Increased Risk of Death among Uninsured Neonates. Health Services Research, 48: 1232–1255. doi: 10.1111/1475-6773.12042
- Issue published online: 4 JUL 2013
- Article first published online: 13 FEB 2013
To estimate the contribution of health insurance status to the risk of death among hospitalized neonates.
Kids' Inpatient Databases (KID) for 2003, 2006, and 2009.
KID 2006 subpopulation of neonatal discharges was analyzed by weighted frequency distribution and multivariable logistic regression analyses for the outcome of death, adjusted for insurance status and other variables. Multivariable linear regression analyses were conducted for the outcomes mean adjusted length of stay and hospital charges. The death analysis was repeated with KID 2003 and 2009.
Of 4,318,121 estimated discharges in 2006, 5.4 percent were uninsured. There were 17,892 deaths; 9.5 percent were uninsured. The largest risks of death were five clinical conditions with adjusted odds ratios (AOR) of 13.7–3.1. Lack of insurance had an AOR of 2.6 (95 percent CI: 2.4, 2.8), greater than many clinical conditions; AOR estimates in alternate models were 2.1–2.7. Compared with insureds, uninsureds were less likely to have been admitted in transfer, more likely to have died in rural hospitals and to have received fewer resources. Similar death outcome results were observed for 2003 and 2009.
Uninsured neonates had decreased care and increased risk of dying.