Research Data from University of Michigan Update Understanding of Health and Medicine (Health Insurance and Interhospital Transfer for Critically Ill Patients With Respiratory Failure): Health and Medicine

2025 OCT 17 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Health and Medicine. According to news reporting originating from Ann Arbor, Michigan, by NewsRx correspondents, research stated, “Importance Critically ill patients with acute respiratory failure may benefit from transfer to higher-volume centers with specialized care. However, health insurance is often considered prior to interhospital transfer and may represent a factor other than severity of illness that influences transfer processes and outcomes for patients with respiratory failure.”

Financial support for this research came from NIH National Heart Lung & Blood Institute (NHLBI).

Our news editors obtained a quote from the research from the University of Michigan, “To examine the association between patient health insurance, interhospital transfer, and mortality for critically ill patients with acute respiratory failure. Setting, and Participants This retrospective cohort study using data from the Premier Healthcare Database included critically ill patients aged 18 years or older with acute respiratory failure receiving mechanical ventilation and intensive care within the first 3 days of hospitalization from January 1, 2017, until September 30, 2021, at academic and community hospitals across the US. Data were analyzed from October 2023 through August 2024. Exposure Patient health insurance, categorized as commercial, Medicaid, Medicare, uninsured, or other. Main Outcomes and Measures Multivariable logistic regression was used to estimate the associations between patient insurance type, receipt of interhospital transfer, and mortality, accounting for age, sex, severity of illness, comorbidities, and year. A shared frailty model was used to examine timing of interhospital transfer by insurance status. There were 703 392 hospital admissions of critically ill patients with acute respiratory failure receiving invasive mechanical ventilation at 824 hospitals. The mean (SD) age patient age was 60.5 (17.0) years, and 400 126 (56.89%) were male; 30 613 (4.35%) underwent interhospital transfer, and 263 261 (37.43%) died or were discharged to hospice. In adjusted analyses, there were lower odds of undergoing interhospital transfer for patients without insurance compared with commercial insurance (adjusted odds ratio [AOR], 0.56; 95% CI, 0.51-0.61; absolute difference in estimated probability of transfer, 2.39 percentage points; P< .001). Patients without insurance experienced significantly higher odds of mortality (AOR, 1.31; 95% CI, 1.25-1.37; P< .001), and having no insurance was associated with slower time to interhospital transfer (adjusted hazard ratio, 0.72; 95% CI, 0.68-0.76; P< .001) compared with having commercial insurance. Conclusions and Relevance In this cohort study, a lack of health insurance was associated with lower odds of interhospital transfer and higher odds of mortality among critically ill patients.”

According to the news editors, the research concluded: “The findings suggest a need to better understand drivers of the interhospital transfer process and ensure that decisions for transfer are made equitably to improve outcomes for critically ill patients.”

For more information on this research see: Health Insurance and Interhospital Transfer for Critically Ill Patients With Respiratory Failure. JAMA Network Open, 2025;8(8). JAMA Network Open can be contacted at: Amer Medical Assoc, 330 N Wabash Ave, Ste 39300, Chicago, IL 60611-5885, USA.

The news editors report that additional information may be obtained by contacting Emily A. Harlan, University of Michigan, Dept. of Medicine, Division of Pulmonary and Critical Care, Ann Arbor, MI 48109, United States. Additional authors for this research include Muhammad Ghous, Noella Cortinas, Thomas S. Valley, Sarah L. Krein, Nandita R. Nadig, Kelly C. Vranas and Mari Armstrong-Hough.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1001/jamanetworkopen.2025.28889. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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