The U.S. Department of Health and Human Services recently released statistics from its 2009 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS), with trend information as far back as 1993. The NIS consists of discharge records for all inpatients treated in a sample of approximately 1,000 hospitals. These discharges are weighted to represent all inpatient stays in community hospitals across the nation, so this report presents national estimates for the country as a whole.
While many of the highlights are to be expected given what we know of trends surrounding us, some are still quite disheartening. One that strikes me in particular regards the uninsured. While the uninsured tend to be younger and not necessarily those who are unemployed, these inpatient hospital statistics suggest a very dark picture of the uninsured. In 2009, the most common reasons for inpatient admission are: 1) alcohol-related disorders; 2) mood-related disorders; 3) non-specific chest pain (as opposed to a clearly diagnosed circulatory condition, for example); and 4) skin and subcutaneous tissue infection. When I combine severe alcohol abuse with mental illness, undiagnosed chest pain, and skin infections, this points to an individual who is grossly neglecting himself or herself, inadequately equipped to cope with life's routine demands, and neglected by others.
Don't misinterpret the data. Lack of health insurance doesn't necessarily cause mental depression or skin infections serious enough to warrant inpatient hospital care. The correlation, however, does point to circumstances that place one at risk. As a society, we have a moral obligation to identify what those safety nets are and make sure that everyone in this country has the basic, necessary set of resources and knows how to access and use them so that such self-abusive behavior can be avoided and inpatient hospital costs can be saved.
Public health education constitutes important threads to weave into the fabric of that net. This is at the heart of the mission of the National Association For Continence so that individuals are armed with what they need to know about about bladder and bowel health so they can regain and maintain control and balance in their lives. Whether insured or not, everyone deserves to be educated about their bodies and how to care and advocate for their health. Get the facts! Get educated! Start with a visit to www.nafc.org
Nancy Muller, PhD, MBA