title: Insurance and education determine survival in infantile coarctation of the aorta.
abstract: Health outcomes are determined by case severity, physician decisions, and patient variables. In a population-based study between 1981 and 1989, 103 cases of infant coarctation of the aorta were diagnosed before one year of age. The goal of this study was to determine whether patient race, gender, income, and insurance status had effects on outcome of coarctation of the aorta that were distinct from the effect of case severity. Survival of infants with coarctation of the aorta, a common congenital cardiovascular malformation, is associated with greater maternal education and with having any health insurance but not with measures of severity. Infants without health insurance are 12.8 times more likely to die than infants with any health insurance. Fifty-five percent of all deaths in infant coarctation occur prior to surgical treatment. One-third of deaths occur without diagnosis. Outcome measures require knowledge of the entire population and of insurance status to inform policy.
authors.affiliation: George Washington University School of Medicine, Washington, D.C., USA.
authors.forename: K S
authors.initials: KS
authors.lastname: Kuehl
authors.forename: J M
authors.initials: JM
authors.lastname: Baffa
authors.forename: G A
authors.initials: GA
authors.lastname: Chase
mesh_terms: D000704:Analysis of Variance; D001017:Aortic Coarctation / Q000175:diagnosis / Q000191:economics / Q000401:mortality* / Q000628:therapy*; D018672:Community Health Planning; D004219:District of Columbia / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008396:Maryland / Q000453:epidemiology; D009035:Mothers / Q000193:education*; D011159:Population Surveillance; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014768:Virginia / Q000453:epidemiology