Inpatient hospital utilization among the uninsured near elderly: data and policy implications for West Virginia.
OBJECTIVE
To inform state policy discussions about the insurance coverage of the near elderly in West Virginia (WV) and the impact of the uninsured near elderly on hospitals in the state.


METHODS
2003 West Virginia Uniform Bill (UB) hospital discharge data. The data represent all adult inpatient discharges in the state during the year.


METHODS
We compare the near elderly with other adults and examine differences by insurance status. Key variables include volume of discharges, health insurance coverage, patient characteristics, and charges incurred.


RESULTS
The near elderly constitute the largest group of nonelderly adult inpatient hospital discharges. They are more likely than younger adults to be admitted for emergency conditions; have comorbidities and complications; have longer hospital stays; and incur higher charges on average. Although the near elderly are least likely to be uninsured, they represent the second largest group of uninsured discharges and incur the most in uninsured charges.


CONCLUSIONS
The specific needs of the near elderly warrant consideration in WV's (and other states') ongoing development and evaluation of policies aimed at reducing uncompensated care costs, including programs to expand access to health insurance and primary and mental health care among the uninsured.
Spencer
Donna L
DL
University of Minnesota School of Public Health, State Health Access Data Assistance Center, 2221 University Avenue, Suite 345, Minneapolis, MN 55414-3164, USA.
Richardson
Sally K
SK
McCormick
Melissa Kolb
MK
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005382:Financing, Personal / Q000191:economics / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008483:Medical Assistance / Q000191:economics / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014903:West Virginia