Do the Poor Cost More? a Multihospital Study of Patients' Socioeconomic Status and Use of Hospital Resources

Abstract

Nearly 17,000 patients admitted to five Massachusetts hospitals in 1987 were interviewed prospectively to determine occupation, education level attained, and household income. The relation of length of hospital stay and hospital charges to occupation, education, and income were examined. After adjustment for diagnostic related groups (DRGs), study findings showed that at these hospitals, patients of lower socioeconomic status required longer stays and higher hospital charges than patients of higher socioeconomic status. The differences often were significant between the two groups, ranging from up to 21% for length of stay to up to 13% for charges. Epstein, et al. argue that on the basis of their findings, supplementary Medicare payments should be provided to all hospitals that care for the poor, not just to those institutions serving large numbers of indigents as is now the case. (KIE abstract)