JR Curtis, W Burke, AW Kassner and ML Aitken
Department of Medicine, University of Washington, Seattle, USA.

Life expectancy for individuals with cystic fibrosis (CF) has increased dramatically in the last 30 yr, but it is unclear whether the improved survival has applied equally to individuals with different health insurance status. We developed a retrospective inception cohort of all 189 patients with CF born 1/1/55 to 12/31/70 who had at least one hospitalization at a university referral center. The median survival for patients with CF who were without health insurance was 6.1 yr compared with 20.5 yr for those with Medicaid and 20.5 yr for those with private insurance. Using multivariate Cox regression, health insurance and increased socioeconomic status were independently associated with longer survival. The adjusted relative risk of death was greater for the absence of health insurance than for factors previously shown to predict mortality in individuals with CF (female sex and presentation with meconium ileus). In summary, the absence of health insurance was associated with increased mortality rate in children with CF and was a stronger predictor of mortality than variables previously shown to be associated with mortality for CF. If increasing numbers of children with CF lose health insurance coverage, our results suggest that their life expectancy will decrease dramatically.

This article has been cited by other articles:

				C. HOFFMAN and J. PARADISE Health Insurance and Access to Health Care in the United States Ann. N.Y. Acad. Sci., June 1, 2008; 1136(1): 149 - 160. [Abstract] [Full Text] [PDF]

				M. G. Slieker, C. S. P. M. Uiterwaal, M. Sinaasappel, H. G. M. Heijerman, J. van der Laag, and C. K. van der Ent Birth Prevalence and Survival in Cystic Fibrosis: A National Cohort Study in the Netherlands Chest, October 1, 2005; 128(4): 2309 - 2315. [Abstract] [Full Text] [PDF]

				C. H. Goss, S. A. Newsom, J. S. Schildcrout, L. Sheppard, and J. D. Kaufman Effect of Ambient Air Pollution on Pulmonary Exacerbations and Lung Function in Cystic Fibrosis Am. J. Respir. Crit. Care Med., April 1, 2004; 169(7): 816 - 821. [Abstract] [Full Text] [PDF]

				C. H. Goss, G. D. Rubenfeld, K. Otto, and M. L. Aitken The Effect of Pregnancy on Survival in Women With Cystic Fibrosis Chest, October 1, 2003; 124(4): 1460 - 1468. [Abstract] [Full Text] [PDF]

				W. Burke Genomics as a Probe for Disease Biology N. Engl. J. Med., September 4, 2003; 349(10): 969 - 974. [Full Text] [PDF]

				G. Henriksson, K. M. Westrin, F. Karpati, A.-C. Wikstrom, P. Stierna, and L. Hjelte Nasal Polyps in Cystic Fibrosis : Clinical Endoscopic Study With Nasal Lavage Fluid Analysis Chest, January 1, 2002; 121(1): 40 - 47. [Abstract] [Full Text] [PDF]

				M. S. SCHECHTER, B. J. SHELTON, P. A. MARGOLIS, and S. C. FITZSIMMONS The Association of Socioeconomic Status with Outcomes in Cystic Fibrosis Patients in the United States Am. J. Respir. Crit. Care Med., May 1, 2001; 163(6): 1331 - 1337. [Abstract] [Full Text]

				J. Randall Curtis and S. Borson Examining the Link between Sarcoidosis and Depression Am. J. Respir. Crit. Care Med., February 1, 2001; 163(2): 306 - 308. [Full Text]