Variations in Health Care Measures by Insurance Status for Patients with a Respiratory System Diagnosis Requiring Intubation and Continuous Ventilator Support

A number of articles have reported that the uninsured and Medicaid populations have higher rates of mortality and morbidity than the privately insured. This study adds to the literature by applying Braveman's distinction between traditional commercial and PPO plans and private HMOs and PHPs to patients in the particularly expensive DRG 475, respiratory system diagnoses requiring intubation and continuous ventilator support, as recorded in a HCUP-3, a large interstate database. The principal finding is that patients covered by the more traditional commercial and PPO insurance plans have the highest inpatient mortality rate and the fewest procedures performed as compared with all other insurance categories. These and other significant differences within the two privately insured categories and between Medicaid and the uninsured populations emphasize the importance of more careful analyses of insurance categories as a determinant of health care access and outcomes