ArticleAnnals of family medicine
Impact of insurance and hospital ownership on hospital length of stay among patients with ambulatory care-sensitive conditions.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Developing a Novel Artificial Intelligence Framework to Measure the Balance of Clinical Versus Nonclinical Influences on Posthepatectomy Length of Stay.Annals of surgical oncology · 2025Article
- Analyzing the 20-year declining trend of hospital length-of-stay in European countries with different healthcare systems and reimbursement models.International journal of health economics and management · 2024Article
- Health Care Use Among Patients Retroactively Insured via a Hospital-Based Insurance Linkage Program.Journal of general internal medicine · 2024Article
- Racial differences in time to blood pressure control of aneurysmal subarachnoid hemorrhage patients: A single-institution study.PloS one · 2023Article
- Article
- Patient Satisfaction Determinants of Inpatient Healthcare.International journal of environmental research and public health · 2021Article
- Factors Associated With Length of Stay in Emergency Departments for Pediatric Patients With Psychiatric Problems.Pediatric emergency care · 2019Article
- The Effects of Chronic Disease on Ambulatory Care-Sensitive Hospitalizations for Children or Youth.Health services insights · 2019Article
- Socioeconomic Factors Affecting Discharge Status of Patients with Uncomplicated Transsphenoidal Adenohypophysectomy.Journal of neurological surgery. Part B, Skull base · 2018Article
- Insurance status, inhospital mortality and length of stay in hospitalised patients in Shanxi, China: a cross-sectional study.BMJ open · 2017Article
- Factors affecting length of stay in teaching hospitals of a middle-income country.Electronic physician · 2016Article
- Impact of preoperative chronic renal failure on liver transplantation: a population-based cohort study.Therapeutics and clinical risk management · 2016Article
- Association of insurance status with health outcomes following traumatic injury: statewide multicenter analysis.The western journal of emergency medicine · 2015Article
- Transferrin saturation and hospital length of stay and mortality in Medicare beneficiaries.Journal of the American Geriatrics Society · 2013Article
- In this issue: health care policy affects the lives of real people.Annals of family medicineArticle
- Where the United States falls down and how we might stand up.Annals of family medicineArticle
- Trends in Medical and Surgical Admission Length of Stay by Race/Ethnicity and Socioeconomic Status: A Time Series Analysis.Health services research and managerial epidemiologyArticle
- Early Determinants of Length of Hospital Stay: A Case Control Survival Analysis among COVID-19 Patients admitted in a Tertiary Healthcare Facility of East India.Journal of primary care & community healthArticle
- Racial/Ethnic Disparities in Readmissions in US Hospitals: The Role of Insurance Coverage.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
PURPOSE Some studies suggest proprietary (for-profit) hospitals are maximizing financial margins from patient care by limiting therapies or decreasing length of stay for uninsured patients. This study examines the role of insurance related to length of stay once the patient is in the hospital and risk for mortality, particularly in a for-profit environment. METHODS We undertook an analysis of hospitalizations in the National Hospital Discharge Survey (NHDS) of the 5-year period of 2003 to 2007 for patients aged 18 to 64 years (unweighted n = 849,866; weighted n = 90 million). The analysis included those who were hospitalized with both ambulatory care-sensitive conditions (ACSCs), hospitalizations considered to be preventable, and non-ACSCs. We analyzed the transformed mean length of stay between individuals who had Medicaid or all other insurance types while hospitalized and those who were hospitalized without insurance. This analysis was stratified by hospital ownership. We also examined the relationship between in-hospital mortality and insurance status. RESULTS After controlling for comorbidities; age, sex, and race/ethnicity; and hospitalizations with either an ACSC or non-ACSC diagnosis, patients without insurance tended to have a significantly shorter length of stay. Across all hospital types, the mean length of stay for ACSCs was significantly shorter for individuals without insurance (2.77 days) than for those with either private insurance (2.89 days, P = .04) or Medicaid (3.19, P <.01). Among hospitalizations for ACSCs, in-hospital mortality rate for individuals with either private insurance or Medicaid was not significantly different from the mortality rate for those without insurance. CONCLUSIONS Patients without insurance have shorter lengths of stay for both ACSCs and non-ACSCs. Future research should examine whether patients without insurance are being discharged prematurely.
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