Uninsured face higher death risk from aort...( e suddenly bursting open unpredictably....),Health

Patients whose aneurysms are found while they're still intact can have surgery to correct the problem, using an artificial graft to bypass the weak area. But those whose aneurysms rupture have a 50 percent chance of immediate death.

In the new study, the U-M team looked at a national sample of 5,363 people under age 65 who had either an intact or ruptured AAA between 1995 and 2000. Thirty-six percent of AAA patients with no insurance suffered a rupture in that time, as opposed to 18 percent of those on Medicaid and 13 percent of those with private insurance. "By the time many of the uninsured seek treatment, it's too late," says Upchurch.

The differences between the uninsured and the insured carried over to the operating table, Upchurch and his colleagues found and those covered by Medicaid didn't fare much better than the uninsured. (The study did not include patients covered by Medicare, because that program offers universal insurance coverage to people aged 65 and older.)

Among AAA patients whose aneurysms were found intact, in time for elective surgery, a small but significant percentage died during the operation or in the hospital after surgery. The rate was 2.6 percent for uninsured patients and 2.7 percent for Medicaid participants, but only 1.2 percent for those with private insurance.

When patients whose aneurysms had ruptured got help fast enough to be brought in for emergency surgery, the odds were stacked high against their survival but they were stacked much higher against those without insurance. More than 45 percent of the uninsured patients died during or immediately after emergency surgery, as compared with 31.3 percent of Medicaid patients and a relatively low 26 percent of patients with private insurance.

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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
23-Sep-2003