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After Hospitalization, Patients Without Health Insurance Are Less Likely to Recover

Health insurance is good to have, if one can afford it, so that a person does not suddenly need an appendectomy and receives a $100,000 hospital bill with no clear idea on how to pay it. However, the benefits of health insurance are not just fiscal – health insurance also has benefits for a person's health. A recent study conducted by researchers at Johns Hopkins University found that people with health insurance were more likely to recover than people with substandard health insurance or without it altogether.

Researchers had previously thought that race was a huge indicator of whether a person would survive after hospitalization. Indeed, African Americans living in low-income, urban neighborhoods have a high burden of hospitalization and early death. However, researchers were uncertain as to the link that they were seeing was correlative with race or with health insurance. Derek Ng, from Johns Hopkins University's Bloomberg School of Public Health, and his team sought to find out.

Ng and his colleagues looked at the admission records of three Maryland hospitals over the years 1997 to 2003. All three hospitals had different demographics, collected from hospitals' own analysis. The study divided patients into three groups: those with private health insurance, those with state health insurance, and those with no health insurance. Of the data researchers analyzed, 4,908 patients were diagnosed with heart attacks, 6,759 with clogged or hardened arteries, and 1,293 with stroke. Patients' income was assessed through Census records. Patient outcomes were assessed with the Social Security Death Master File.

In all three diagnoses, when adjusted for race, age, disease severity, and average neighborhood income, health insurance was the biggest indicator of whether or not a person would recover after hospital admission. Those without health insurance or with insufficient health insurance were 31 percent less likely to survive after a heart attack and 50 percent less likely after a diagnosis of clogged or hardened arteries. Across racial lines, survival rates were about equal after suffering from a heart attack or stroke, and black people were in fact slightly more likely to recover from hardened or clogged arteries.

President Obama made health care reform a key target of his first term of office. The Affordable Care Act was passed in 2010, modeled after former Massachusetts governor Mitt Romney's plan. In June of this year, the Supreme Court upheld the contentious individual mandate, but did not require that states joined the Medicaid expansion. Recent estimates by the Congressional Budget Office say that the Medicaid expansion would be disastrous for states that choose to join it.

Ng's study was published in the Journal of General Internal Medicine.

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