Differences in Thirty Day Healthcare Encounters Following Hospitalization in an Insured and Uninsured Population: A Retrospective Study
Objective: To describe the incidence of 30 day healthcare encounters following an index hospitalization in an uninsured and insured population.
Methods: This was a retrospective cohort study conducted at an urban, tertiary care hospital. Patients admitted between 7/1/2010 - 6/30/2011 that were between the ages of 18-64 were included if they had a financial code for no insurance or commercial insurance provider. The primary outcome assessed between groups was incidence of 30 day healthcare encounter following hospital disharge to either the emergency department or hospital.
Results: 5,489 patients were admitted over the study period 2,093 uninsured and 3,396 insured. The number of 30 day healthcare encounters for the uninsured and insured groups were 348 (16.6%) and 566 (16.7%), respectively (p = 0.99). The uninsured population was more likely to be have a 30 day healthcare encounter in the emergency department 237 (11.3%) vs 246 (7.2%), p <0.001. The uninsured group with a 30 day healthcare encounter were younger and more likely reside in a urban zip code. Conditions most frequently cited in 30 day healthcare encounter in the uninsured were abdominal pain, infections, diabetes, chronic pain and angina.
Conclusion: This analysis demonstrated no difference in incidence of 30 day healthcare encounters between an insured and uninsured population. However, the uninsured population was more likely to be seen in the emergency department at 30 days.
Zachary R. Smith, Nadia Z. Haque, James S. Kalus