Insurance Coverage Affects Mortality in Abused Infants, According to New Cincinnati Children’s Study

Monday, January 01, 0001

A new study has found that death rates in infants due to abuse vary according to whether children have insurance coverage.

The multi-center study, presented Oct. 11 at the annual meeting of the American Academy of Pediatrics in Boston, shows that infants without private insurance are three to four times more likely to die compared to those with private insurance. In addition, those from a zip code with a median income level below $30,738 were 3.5 to 6.75 times more likely to die compared to those from higher income zip codes.

The study involved nine pediatric trauma centers throughout the United States. Richard A. Falcone Jr., MD, a pediatric surgeon at Cincinnati Children’s Hospital Medical Center and associate director, Trauma Services, who led the study, and his colleagues identified 867 infants under the age of 1 who were victims of abuse during a five-year period. Their overall mortality rate was 8.8 percent. Patients without private insurance had a risk of dying 3.8 times that of infants with insurance, even when race, injury severity and responsiveness as measured by Glasgow Coma Scores were taken into account.

"Potential causes for this disturbing difference include access to care and quality of care provided both before and after the injury, family and social stresses, and environmental factors associated with low income," says Dr. Falcone. "The differences we found are unacceptable and demonstrate a need for more research to help us better understand such variations in outcomes and reduce these disparities. It will be necessary to evaluate and implement changes both in the health care system itself and in policy that affects insurance and economic status."

The study is the first multi-center report demonstrating significant differences in mortality among abused infants based on insurance status.

Cincinnati Children's is one of America’s top three children’s hospitals for general pediatrics and is highly ranked for its expertise in digestive diseases, respiratory diseases, cancer, neonatal care, heart care and neurosurgery, according to the annual ranking of best children's hospitals by U.S. News & World Report. One of the three largest children’s hospitals in the U.S., Cincinnati Children’s is affiliated with the University of Cincinnati College of Medicine and is one of the top two recipients of pediatric research grants from the National Institutes of Health.

For its achievements in transforming healthcare, Cincinnati Children's is one of six U.S. hospitals since 2002 to be awarded the American Hospital Association-McKesson Quest for Quality Prize ® for leadership and innovation in quality, safety and commitment to patient care. The hospital is a national and international referral center for complex cases, so that children with the most difficult-to-treat diseases and conditions receive the most advanced care leading to better outcomes.