Working with scientists on a national project about healthcare and poverty, cardiology researchers at Kansas City’s St. Luke’s Hospital have been poring over the records of heart patients nationwide to determine if there are observable differences between the treatment of uninsured versus insured patients. Unfortunately, the findings indicate that uninsured patients are much more likely to suffer from medical negligence.
St. Luke’s cardiologist and researcher Paul Chan had previously shown that people who have no health insurance are substantially more likely to delay going to the hospital, even when they are experiencing symptoms of a heart attack. They are also less likely to be given CPR by bystanders.
In this new study, Chan and his colleagues looked at data combined from 61,000 patient records from some 30 practices across the nation. Then, they compared the healthcare options accessed by the uninsured with those who had health insurance.
According to the study, uninsured heart disease patients were 6 to 12 percent less likely to have been prescribed medications essential for the care of heart disease. They also received the least competent care in practices that serve a lot of uninsured patients. When they went to clinics with fewer uninsured patients, they received better care.
Why? Chan pointed out that practices that largely serve the uninsured are often “safety net” practices that are crowded with very sick people. That could mean that doctors only have time to treat the most urgently sick patients or only the most serious issues for each patient. Some doctors, he says, may not bother writing prescriptions for the poor because many drugs are too expensive for them to fill. And, doctors who are willing to work in low-cost clinics for the uninsured might be of lesser quality and more inclined to medical negligence.
If these suppositions are true, when the majority of Americans have insurance through the new health care law, the situation ought to improve out of the simple application of market forces.
“If a practice is underperforming, now patients will have more options,” he explained. “Patients may not know what medications they need, but they do know if they’ve been short-shrifted with face time.”
Source: The Kansas City Star, “Alarming holes in the medical safety net,” Alan Bavley, March 7, 2013