Role of health insurance on the survival of infants with congenital heart defects

James E. Kucik, Cynthia H. Cassell, Clinton J. Alverson, Pamela Donohue, Jean Paul Tanner, Cynthia S. Minkovitz, Jane Correia, Thomas Burke, Russell S. Kirby

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)e62-e70
JournalAmerican journal of public health
Issue number9
StatePublished - Sep 2014

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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