The lack of insurance of elderly patients and the impact on their health and functional capacity

Hippokratia 2004, 8(1):40-43

IA Vogiatzis, A Kotsani, T Karamitsos, E Kambitsi, IM. Vogiatzis
Cardilogy Dpt, General Hospital of Veria, Veria, Greece
Otolaryngology Dpt, General Hospital of Veria, Veria, Greece


Background: A relatively large proportion of the elderly population receives inadequate health care, mainly due to lack of Health Insurance, since this seems to be a rising social problem over the last years.
The aim of this study is to evaluate the overall functional and health state of hospitalized elderly patients without Health Insurance.
Subjects and Methods: A total of 136 old-aged patients presenting with common health problems were enrolled in the study. In-hospital care costs were borne by an insurance company in 68 of them, (Group B, 38 males- 30 females, mean age 73.6±8.5 years), whereas the rest 68 patients lacked any form of Health Insurance (Group A, 40 males – 28 females, mean age 72.5±5.32 years). Clinical and epidemiological data of both groups were analyzed, focusing on functional state, wellbeing and mortality on admission, 6 months and 1 year after discharge, by which time 40 patients of the 1st group (Group A) were already enrolled in a Public Health Insurance Program (Group C , 28 males – 12 females, mean age 71.4± 4.5 years).
Results: Elderly patients without Health Insurance were functionally impaired and in a worse state of health compared to those with any form of Health Insurance (21.6 % vs 12.8 %, p: 0.02). During the follow-up period, patients with recently acquired Health Insurance presented with a better quality of life, (12.8 %, p: 0.04), but still remained at a lower level when compared to those of Group B (Group A: 48.7 % – Group C: 22.5 % vs Group B: 10.7 %, p: 0.01). Mortality rates were significantly lower in Group B, as well (Group A: 13.4 % – Group C: 8.3 % vs Group B: 2.8 %, p < 0.001).
Conclusion: Poor functional state, bad health and higher rates of mortality in the elderly are closely related to the lack of Social and Health Insurance.