TY - JOUR
T1 - Role of health insurance on the survival of infants with congenital heart defects
AU - Kucik, James E.
AU - Cassell, Cynthia H.
AU - Alverson, Clinton J.
AU - Donohue, Pamela
AU - Tanner, Jean Paul
AU - Minkovitz, Cynthia S.
AU - Correia, Jane
AU - Burke, Thomas
AU - Kirby, Russell S.
PY - 2014/9
Y1 - 2014/9
N2 - Objectives. We examined the association between health insurance and survival of infants with congenital heart defects (CHDs), and whether medical insurance type contributed to racial/ethnic disparities in survival. Methods. We conducted a population-based, retrospective study on a cohort of Florida resident infants born with CHDs between 1998 and 2007. We estimated neonatal, post-neonatal, and infant survival probabilities and adjusted hazard ratios (AHRs) for individual characteristics. Results. Uninsured infants with critical CHDs had 3 times the mortality risk (AHR = 3.0; 95% confidence interval = 1.3, 6.9) than that in privately insured infants. Publicly insured infants had a 30% reduced mortality risk than that of privately insured infants during the neonatal period, but had a 30% increased risk in the post-neonatal period. Adjusting for insurance type reduced the Black- White disparity in mortality risk by 50%. Conclusions. Racial/ethnic disparities in survival were attenuated significantly, but not eliminated, by adjusting for payer status.
AB - Objectives. We examined the association between health insurance and survival of infants with congenital heart defects (CHDs), and whether medical insurance type contributed to racial/ethnic disparities in survival. Methods. We conducted a population-based, retrospective study on a cohort of Florida resident infants born with CHDs between 1998 and 2007. We estimated neonatal, post-neonatal, and infant survival probabilities and adjusted hazard ratios (AHRs) for individual characteristics. Results. Uninsured infants with critical CHDs had 3 times the mortality risk (AHR = 3.0; 95% confidence interval = 1.3, 6.9) than that in privately insured infants. Publicly insured infants had a 30% reduced mortality risk than that of privately insured infants during the neonatal period, but had a 30% increased risk in the post-neonatal period. Adjusting for insurance type reduced the Black- White disparity in mortality risk by 50%. Conclusions. Racial/ethnic disparities in survival were attenuated significantly, but not eliminated, by adjusting for payer status.
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U2 - 10.2105/AJPH.2014.301969
DO - 10.2105/AJPH.2014.301969
M3 - Article
C2 - 25033158
AN - SCOPUS:84906088013
SN - 0090-0036
VL - 104
SP - e62-e70
JO - American journal of public health
JF - American journal of public health
IS - 9
ER -