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Does insurance coverage play a task by which critically ailing sufferers dwell or die? The unlucky reply could also be sure, due partially to a distinction within the price of inter-hospital switch, based on new analysis from the College of Michigan. The work is revealed within the journal JAMA Community Open.
The analysis crew, led by Emily Harlan, M.D. and Thomas Valley, M.D. of the Division of Pulmonary and Essential Care Drugs, examined the components that decided which critically ailing sufferers with acute respiratory failure have been transferred to high-volume specialty hospitals for therapy.
Care in such hospitals is related to a decrease threat of demise for sufferers on a ventilator.
“We were motivated to do this study because there are times that as doctors, we get a call from an outside hospital asking us to accept a patient for transfer to our ICU. We’ll accept a patient, but then we’re told that the patient’s insurance needs to be reviewed first. We wanted to see if those experiences were unique to us,” famous Valley.
“There are laws in place to ensure that anyone who needs emergency care is stabilized and admitted to the hospital. But those laws tend to end there. If a patient needs more advanced treatments at another hospital, there is nothing that requires hospitals to accept those patients for transfer—that’s where factors like a patient’s insurance might play a role.”
The researchers checked out information from greater than 700,000 sufferers from all through the U.S. who have been critically ailing and on ventilators between 2017 and 2021. Over half have been insured via Medicare, 19% via Medicaid, 18% via industrial insurance coverage and 6% have been uninsured.
After controlling for affected person traits, reminiscent of age, intercourse, continual diseases, severity of sickness and the 12 months they have been admitted (to account for the COVID-19 pandemic), the crew found that round 4% of sufferers underwent inter-hospital switch and 37% of sufferers died or have been discharged to hospice.
The percentages of switch for sufferers with out insurance coverage have been practically half that of sufferers with industrial insurance coverage. Sufferers with Medicare or Medicaid have been additionally much less more likely to obtain inter-hospital switch than these with industrial insurance coverage. Sufferers with out insurance coverage or with Medicare or Medicaid have been additionally transferred later throughout their hospital stays than sufferers with industrial insurance coverage.
Moreover, sufferers with out insurance coverage had considerably greater odds of demise relative to sufferers with industrial insurance coverage.
This examine provides to the rising physique of proof of a relationship between insurance coverage standing and inter-hospital switch for severe well being circumstances.
“We need to further evaluate how hospitals make decisions to transfer patients to ensure transfer decisions are made equitably,” stated Harlan.
Extra data:
Emily A. Harlan et al, Well being Insurance coverage and Interhospital Switch for Critically Sick Sufferers With Respiratory Failure, JAMA Community Open (2025). DOI: 10.1001/jamanetworkopen.2025.28889
Supplied by
College of Michigan
Quotation:
Individuals with out medical health insurance are much less more likely to get hold of life-saving hospital transfers, evaluation finds (2025, August 26)
retrieved 26 August 2025
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