A new study by the Medical University of South Carolina found that patients without insurance tend to have shorter hospital stays than those who have private insurance or Medicaid. The findings were published in the November/December issue of Annals of Family Medicine.
MUSC family science professor Dr. Arch Mainous said he and his colleagues examined data from the National Hospital Discharge Survey for patients aged 18 to 64 years, or roughly 90 million hospitalizations nationwide. Those 65 and older were not included because they were covered by Medicare.
Mainous said the trend was consistent whether the person had a preventable condition or not, “When we look at people with the same diagnoses, and we adjust for how sick they are, their age, their race, and their sex,” he said, “What we find is that those people without insurance tend to have shorter lengths of stay.”
Recent estimates suggest as many as 46 million Americans under age 65 are uninsured.
The study found the transformed mean length of stay for those without insurance was 2.77 days, versus 2.89 days for those with private insurance and 3.19 days for Medicaid recipients.
“In some ways, I was not completely surprised,” Mainous said, “Think about trying to run a successful business… How much free stuff, essentially, can you give out and still run your business?”
He said there two likely implications for the research: for-profit hospitals could be prematurely discharging uninsured patients that are not paying for their care or hospitals could be keeping insured patients longer than necessary.
“If they run it like a business, they would want to keep paying patients in and minimize the impact on their bottom line from people who can’t pay,” Mainous said, “I don’t think that’s surprising.”
However, the study was not able to use the data to determine what happened to the person after they left the hospital. Mainous said that means it’s not possible to know if those uninsured who were discharged early were, in fact, released prematurely.
Mainous said a future study is necessary to determine if that is true.