Compared to insured patients, the hospitalizations of uninsured patients are typically shorter and have a lower cost per stay, an April statistical brief from the Agency for Healthcare Research and Quality (AHRQ) and the Healthcare Cost and Utilization Project (HCUP) has found.
Uninsured patients are typically hospitalized for 3.8 days vs. 4.7 days for insured patients and have a lower cost per stay ($7,300 vs. $9,200).
The AHRQ brief looks at characteristics of uninsured hospitalizations, such as utilization, diagnosis, cost and geographic location. Uninsured stays are compared with the characteristics of insured hospital stays, which include private insurance and government programs such as Medicaid and Medicare. The data analyzed is from HCUP's nationwide inpatient sample on uninsured hospital stays in 1998, 2003 and 2008.
In 2008, the uninsured accounted for 2.1 million inpatient hospitalizations, or 5.3% of all U.S. community hospital stays, researchers found.
After remaining fairly constant between 1998 and 2003, number of uninsured hospital stays increased by 21% from 2003 to 2008. Although the authors provide no reason for the increase it probably reflects the increase in the number of uninsured as employers have dropped coverage and nonemployee-sponsored premiums have increased beyond what is affordable for a growing segment of the U.S. population.
Because most patients age 65 and older are covered by Medicare, uninsured stays are predominantly for patients younger than 65 years of age. In a telephone interview, P. Hannah Davis, MS, one of the authors, said that the age differential could account at least in part for the shorter hospital stay as well as the primary reason for the hospital stay among the uninsured: childbirth, which account for 11% of those hospitalizations.
From 2003 to 2008 uninsured hospitalizations for skin infections increased by 55% while hospital stays for gallbladder disease posted a 43% increase and diabetes complications increased by 40%. Uninsured alcohol-related hospitalizations, which posted a significant 18% decline from 1998 to 2003, increased by 35% from 2003 to 2008.
Davis noted that in general the severity of illness was lower for uninsured versus insured hospitalizations. For example, the uninsured had fewer chronic conditions per patient (2.5 vs. 3.5).
Geographically, a larger share of hospital stays in the South were uninsured (7.6 percent) compared to 4.9 percent in the Midwest, 3.6 percent in the West and 3.2 percent in the Northeast, the data showed.
Uninsured hospitalizations accounted for 8.3 percent of stays in public hospitals but only 4.7% of stays in private, nonprofit hospitals.
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Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
