미국공중보건학회지 최신호에 실린 데이비드 힘멜스테인 교수팀의 “건강보험과 미국 성인의 사망율”이라는 논문의 요약문입니다.
미국에서는 해마다 4만5천명(매 12분마다 1명)이 무보험으로 제때 치료를 받지 못해 사망한다는 데이터를 제시하고 있습니다.
데이비드 힘멜스테인 교수팀은 사적보험에 가입한 사람과 비교할 때 보험에 가입하지 못한 사람(무보험자)은 사망할 위험이 25%나 높다는 놀라운 연구 결과를 발표했습니다.
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Research and Practice
Health Insurance and Mortality in US Adults
출처 :American Journal of Public Health,published online ahead of print Sep 17, 2009
http://www.ajph.org/cgi/content/abstract/AJPH.2008.157685v1
Andrew P. Wilper 1*,
1 University of Washington School of Medicine
2 Cambridge Health Alliance/Harvard Medical School
* To whom correspondence should be addressed. E-mail: wilp9522@u.washington.edu .
Abstract
Objectives. A 1993 study found a 25% higher risk of death among uninsured compared with privately insured adults. We analyzed the relationship between uninsurance and death with more recent data.
Methods. We conducted a survival analysis with data from the Third National Health and Nutrition Examination Survey. We analyzed participants aged 17 to 64 years to determine whether uninsurance at the time of interview predicted death.
Results. Among all participants, 3.1% (95% confidence interval [CI]=2.5%, 3.7%) died. The hazard ratio for mortality among the uninsured compared with the insured, with adjustment for age and gender only, was 1.80 (95% CI=1.44, 2.26). After additional adjustment for race/ethnicity, income, education, self- and physician-rated health status, body mass index, leisure exercise, smoking, and regular alcohol use, the uninsured were more likely to die (hazard ratio=1.40; 95% CI=1.06, 1.84) than those with insurance.
Conclusions. Uninsurance is associated with mortality. The strength of that association appears similar to that from a study that evaluated data from the mid-1980s, despite changes in medical therapeutics and the demography of the uninsured since that time.
Key Words: Insurance, Health Financing, Access to Care, Mortality, Surveys
