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

J.E. Kucik, C.H. Cassell, C.J. Alverson, P. Donohue, J.P. Tanner, C.S. Minkovitz, J. Correia, T. Burke and R.S. Kirby

American Journal of Public Health, 2014, vol. 104, issue 9, e62-e70

Abstract: 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.

Keywords: ancestry group; article; birth weight; congenital heart malformation; ethnic group; ethnology; female; health insurance; human; Kaplan Meier method; male; medically uninsured; mortality; newborn; newborn intensive care; prenatal care; register; retrospective study; socioeconomics; statistics; United States, Birth Weight; Continental Population Groups; Ethnic Groups; Female; Florida; Heart Defects, Congenital; Humans; Infant, Newborn; Insurance, Health; Intensive Care Units, Neonatal; Kaplan-Meier Estimate; Male; Medically Uninsured; Prenatal Care; Registries; Retrospective Studies; Socioeconomic Factors (search for similar items in EconPapers)
Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.301969_0

DOI: 10.2105/AJPH.2014.301969

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