Universal Insurance Research Articles

Characteristics of Patients Sponsored by the Internet Platforms of Medical Mutual Aid

The morbidity and mortality of life-threatening diseases such as cancers are increasing year by year in China. Although the national medical insurance has been improved a lot, it still falls short of expecting “universal medical insurance”. To help the families of patients with cancer and other serious diseases to resolve the unaffordable medical cost, several internet platforms of “Peer to Peer Medical Mutual Aid” have gradually emerged recently. In the form of low threshold insurance combined with public support, these platforms provide subsidies to families of patients suffering from serious financial burden and then partly compensate them for the limit of national medical insurance. This article summarized the characteristics of declared patients sponsored by several medical mutual aid internet platforms. The results showed that the sponsored patients were mostly cancer patients (90.1%), aged 21 - 60 (88.4%), and the average amounts of financial support had a trend to decrease with the increase of age. In particular, the reported cases of thyroid cancer were increased dramatically recently, however, with a lowest average mutual aid fund. Given these data, it is urgent to list out a detailed rule for the use of national medical insurance on the treatment of cancer, to heighten the healthcare system for the occupational population, age from 21 to 60, and to establish the credit system for Medicare and Medicaid services.

Regional Disparity in Dental Care Utilization in Japan: Ecological Study Using the National Database of Health Insurance Claims

Background: We examined regional disparities in dental care utilization and their associations with dental care utilization and socioeconomic factors in Japan. Methods: Using the Fourth NBD Open Data Japan, a database for the universal healthcare insurance claims, we conducted an ecological study by analyzing 216 million pieces of aggregated data from April 2017 to March 2018. We used nine indicators to represent dental care utilization: outpatient visits, outreach services, cavity fillings, pulpectomies, dental calculus removals, periodontal surgeries, tooth extractions, dental bridges, and dentures. Standardized claim ratios (SCRs) for these indicators were calculated for Japan’s 47 prefectures, each of which was divided into three groups based on socioeconomic factors (i.e., average income per capita and the proportion of university enrollments). Kruskal-Wallis tests were performed among the three groups to examine the associations between the supply-adjusted nine indicators and the socioeconomic factors. Findings: The ratios between the maximum and minimum SCRs were 1·4 for outpatient visits, 19·3 for outreach services, and 17·6 for periodontal surgeries. Income level was negatively associated with dental bridges and dentures. Educational level was positively associated with outreach services and dental calculus removals, and negatively associated with pulpectomies, tooth extractions, dental bridges, and dentures. Interpretation: In Japan, regional disparities in dental care utilization exist for periodontal care and outreach services but are smaller for urgent and substantial dental care. Educational level appears to be a more important determining factor than income level in dental care utilization. Funding Statement: This work was supported in part by a Health and Labour Sciences Research Grant (Multidisciplinary research project on measures against lifestyle-related diseases such as cardiovascular diseases and diabetes mellitus) “Research study aimed at the development of new evaluation indices and new evaluation methods for the preservation of dental and oral health: Health service research aimed at reducing health disparities in Japan” received by the principal investigator, Nanako Tamiya (Grant number: H31-19FA1001). Declaration of Interests: Takahiro Mori: His appointment as an associate professor at the University of Tsukuba was sponsored by JMDC Inc. in the financial year 2018 (i.e., April 2018 – March 2019), by SMS CO., LTD. in the financial year 2019 (i.e., April 2019 – March 2020), and by FAST DOCTOR CO., LTD in the financial year 2020 (i.e., April 2020 – present). JMDC Inc., SMS CO., LTD, and FAST DOCTOR CO., LTD did not play any role in the conception, design, conduct, or reporting of this study. Sakata Nobuo: His appointment as an associate professor at the University of Tsukuba was sponsored by JMDC Inc. in the financial year 2020 (i.e., April 2020 – present). JMDC Inc. did not play any role in the conception, design, conduct, or reporting of this study. The other authors declare they have no competing interests. Ethics Approval Statement: This study was approved by the University of Tsukuba Medical Ethics Committee (date of approval: December 17, 2019; approval number: 1446).

Fifity years after the identification of the cause of SMON

SMON (subacute myelo-optico-neuropathy) is toxic neurological disease which had a profound impact on the population in Japan in 1960's. The clinical characteristics of SMON includes an ascending sensory disturbance, spasticity, and visual impairment typically following abdominal symptoms. Infection was first suspected as an underlying cause of this epidemic. The disorder was ultimately attributed to the overuse of clioquinol, based on the analysis of green urine from affected patients and confirmed by the epidemiological surveys and experimental animal studies. The factors that contributed to the prevalence of SMON which remains the worst example of drug-associated toxicity in Japan to date include the conversion of clioquinol from a purely topical agent to an orally-administered drug, dogma associated with drug safety, relatively limited regulation of drug use, an increase in the number of prescriptions due to the availability of universal insurance, as well as the complexity of the associated abdominal symptoms. Periodical examination of the patients diagnosed with SMON continues to this day. As such, it is important to have a better understanding of clioquinol-induced neurotoxicity together with the mechanisms underlying drug susceptibility; we should not permit the memory of this severe and prominent drug-associated toxicity fade from view.

Impact of Health Systems on Life Expectancy in Taiwan, Singapore, and the USA: Similarities and Differences

Like Singapore, Taiwan has universal health care and universal long-term care (LTC). The USA has neither. Those who need LTC in the US pay out of pocket, buy private LTC insurance or spend down to qualify for Medicaid; there are inherent issues related to cost and quality. For example, nursing home care costs over US$100,000/year and only about 8% of the population has private LTC insurance. Many people become impoverished or struggle financially to qualify for Medicaid. Conversely, Taiwan has universal LTC insurance that offers comprehensive services for all, but it is relatively new and its impact remains to be seen. Similarities and differences related to LTC quality indicators such as functional independence, and the NCQA quality measures (e.g., effectiveness of care, access/availability) in Taiwan, Singapore and the US will be presented. The results of this comparison can inform policy makers and stakeholders leading to best practices. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.

Predictors of subsequent injury at work: findings from a prospective cohort of injured workers in New Zealand

ObjectivesPeople who have experienced a work-related injury can experience further work injuries over time. This study examines predictors of subsequent work-related injuries over 24 months among a cohort of injured...

The epidemiology of acute coronary syndromes in French Guiana

BackgroundFrench Guiana is an overseas territory of France with marked specificities in terms of populations, socioeconomic factors, risk factors, and an access to care. In this context, the objective of the present study was to describe the epidemiology of acute coronary syndromes in French Guiana and to make comparisons with mainland France and neighbouring country. MethodsThe data were obtained from a retrospective descriptive hospital-based cohort conceived to describe the incidence of acute coronary syndromes and their epidemiologic and clinical characteristics. It included patients aged 18 or more hospitalised for a first coronary syndrome in the reference centre for coronary syndromes in Cayenne French Guiana between Jan 1st 2012 and Dec 31st 2014. Overall, 266 patients were analysed. ResultsThe mean age was 64 years (SD=12.54). A majority of patients were men (sex ratio=1.83). The proportion of patients born in an overseas French territory (44.36%) was similar to that of those born in a foreign country (43.98%), and 11.65% were born in mainland France. Only 59% of patients had regular health insurance. Moreover, 33.21% had universal medical insurance (CMU for those below a minimal income), 4.91% had state insurance (for illegal foreign patients) and 2.64% had no insurance at all. The main risk factors were high blood pressure (73.68%), diabetes (39.85%), hypercholesterolemia (40.23%), and smoking (37.97%). Overall, 82/266 patients developed an ST elevation coronary syndrome (STEMI) and 184/266 had a non-ST elevation coronary syndrome NSTEMI or unstable angina pectoris. Thrombolysis was only performed in 20.73% of patients with STEMI. Mortality at 1 month was 8/82 (9.76%) for STEMI and 2/184 (1.09%) for NSTEMI. ConclusionsThe epidemiologic profile of acute coronary syndromes in French Guiana is different from that of mainland France and Europe to the neighbouring country Brazil. Mortality of STEMI also seems higher than in mainland France, but similar to Brazil. In a context of frequent health inequalities, interventions targeting the major risk factors, notably high blood pressure, obesity and diabetes, have the potential to significantly impact cardiovascular morbidity and mortality.

Comprehensive Dental Care in Canada: The Choice Between Denticaid and Denticare

A healthy mouth is an essential ingredient for overall good health, but a Canadian’s access to comprehensive dental care is dependent on their ability to attain private insurance. This paper seeks to estimate the gross and net total cost of two policy options for introducing comprehensive dental care into Canadian Medicare. Using a micro-costing approach for estimating the annual clinical costs, and an average-costing approach for annual administrative expenses, this paper estimated the total cost of universal first dollar dental coverage (denticare) and public dental insurance for children and uninsured adults in Canada (denticade). If the denticare option was implemented in the year 2019, the gross total public-sector cost would to be roughly $15.68 billion. This would replace the current $1.02 billion spent on existing public health dentistry programs and $6.27 billion spend on public employee’s dental plans. The total cost could be further offset by the inclusion of income-tiered premiums set at a maximum rate below private insurance provider prices. The net total cost of denticare would then be an aggregate decrease in public spending by $127.08 million. If the denticade option was implemented in the year 2019, the gross total public-sector cost would to be roughly $8.43 billion. This would replace the current $1.02 billion spent on existing public health dentistry programs but would not replace spending on public employee’s dental plans. The total cost could be further offset by the inclusion of income-tiered premiums and copayments. The net total cost of denticade would an aggregate increase in public spending by $1.41 billion. The results of this costing analysis demonstrate that by pursuing the universal first-dollar coverage option, Canadians taxpayers could see a reduction in tax-based spending and a considerable decrease in dental premiums changed than if the denticade approach was pursued.

Subscription channels and reasons for insurance according to life insurance and indemnity insurance products through correspondence analysis

본 연구는 보험연구원에서 2018년 실시한 보험소비자설문조사 데이터를 기반으로 생명보험상품과 손해보험 상품별 가입채널과 각 해당 보험상품들에 대한 가입 이유를 시각화 분석방법인 대응분석을 통해 분석하였다. 생명보험 상품들의 가입채널을 보면, 실손의료보험, 종신보험, 변액유니버셜종신, 변액유니버셜연금, 질병보장보험은 주로 설계사 채널과 밀접한 관련이 있으며, 상해보험은 인터넷과 TM, 홈쇼핑 채널들과 관련이 있으며, 변액종신, 어린이보장보험과 정기사망보험은 보험회사 임직원 채널과 관련이 높았다. 저축성보험과 연금보험은 은행과 증권회사 채널과 관련이 높게 나타났다. 반면에 손해보험 상품들의 가입채널을 보면, 실손의료보험, 질병보장보험, 운전자/장해의 장기 상해보험, 간병보험은 설계사 채널과 밀접한 관련이 있으며, 자동차보험은 인터넷 채널과 설계사 채널과 관련성이 높은 것으로 나타났다. 저축성보험은 TM, 보험회사직원, GA와 관련성이 있고 종합보험은 홈쇼핑과 관련이 있는 것으로 나타났다. 생명보험 상품과 손해보험 상품들의 가입 채널을 종합해 보면 주계약과 특약이 포함되어 상품의 특성이 복잡하여 구체적인 설명이 필요한 상품들은 설계사 채널이 선호되었다. 저축성보험과 연금보험은 은행과 증권회사 채널이 선호되었고, 자동차보험과 같이 정형화가 가능한 보험상품은 인터넷 채널이 선호되는 경향을 보였다.This study analyzed the subscription channels for life insurance products and indemnity insurance products and the reasons for subscribing each of the insurance products through the corresponding analysis, a visualization analysis method, based on the insurance consumer survey data conducted in 2018 by the Korea Insurance Research Institute. Looking at the subscription channels of life insurance products, loss medical insurance, whole life insurance, variable universal life insurance, variable universal annuities, and disease coverage insurance are mainly related to the life planner channel, and injury insurance is related to the internet, TM, and home shopping channels. In addition, variable whole life insurance, children s security insurance and term death insurance were related to the insurance company s employee channels. Savings insurance and annuity insurance were highly related to banks and securities companies. On the other hand, if you look at the subscription channels of indemnity life insurance products, loss medical insurance, disease insurance, long-term injury insurance for driver/disability, and care policy are closely related to the life planner channel, and auto insurance is highly related to the internet channel and the life planner channel. Appeared. It was found that savings insurance was related to TM, insurance company employees and GA, and comprehensive insurance was related to home shopping.

Implementation of health and health-related sustainable development goals: progress, challenges and opportunities – a systematic literature review

IntroductionWhile health is one of the Sustainable Development Goals (SDGs), many other ‘health-related’ goals comprise determinants of health. Integrated implementation across SDGs is needed for the achievement of Agenda 2030....

Medical insurance and healthcare utilization among the middle-aged and elderly in China: evidence from the China health and retirement longitudinal study 2011, 2013 and 2015

BackgroundIn response to China’s rapidly aging population and increasing healthcare service demands, the Chinese government is developing a universal medical insurance system. This study aimed to assess healthcare utilization patterns and analyze the impacts of medical insurance schemes on healthcare utilization among the middle-aged and elderly in China.MethodsData was extracted from the China Health and Retirement Longitudinal Study in 2011, 2013 and 2015. Healthcare utilization was measured by outpatient and inpatient service utilization. Univariate analysis was deployed to examine the impacts of different medical insurance schemes on healthcare utilization. The factors associated with healthcare utilization were estimated using a random-effects logistic regression model.ResultsDuring the study period, the number of individuals involved was 17,250, 18,195 and 19,842, respectively. The proportion of individuals who received outpatient service was 18.6, 20.7 and 18.7% and those who used inpatient service was 9.6, 13.8 and 14.3%, respectively. We identified that medical insurance was a major protective factor for improving healthcare utilization but different medical insurance schemes exerted various impacts on the middle-aged and the elderly.ConclusionsDespite the growing population coverage, the Chinese government should make every effort to bridge the gap among people with different medical insurance schemes. Further evaluation is needed to assess whether the expanded medical insurance schemes could protect the middle-aged and elderly households from catastrophic health expenditure.

Behavioural politics: social insurance and mutual benefit in Robert Sugden’s The Community of Advantage

In The Community of Advantage, Robert Sugden advocates a system of universal social insurance to ensure that all citizens enjoy the benefits of market institutions. The Community of Advantage however does not shed light on the extent of redistribution that social insurance should provide. While the criterion of mutual advantage seems to licence only a minimal level of insurance, people’s expectations and collective bargaining power are likely to lead to a much more extensive redistribution. This is not necessarily a bad thing, since a well-functioning society is more than a well-functioning market economy. An extensive social insurance protects the rich, the poor, and, above all, the cooperative attitudes without which a democratic society cannot function well.

Determinants of long-term care insurance applications in South Korea.

South Korea established universal long-term care insurance (LTCI) in 2008. However, actual requests for LTCI remain lower than government estimates because some eligible candidates never apply despite their strong care needs. This study aimed to examine factors affecting LTCI applications for older, community-dwelling Koreans. Both individual- and community-level data were obtained from a national dataset from the Korea Health Panel Survey and the Korea National Statistical Office (N=523). Data were analyzed using multilevel modeling. Only 16.4% of older adults in need of care applied for LTCI. Those who applied were more likely to be older, report poor self-rated health, receive care from non-family caregivers, and have caregivers experiencing high levels of caregiving burden. Regional differences in LTCI applications existed concerning the financial condition of one's community. Our study findings emphasize that Korean LTCI should implement both individual and community strategies to better assist older adults in properly acquiring LTCI. The government should make comprehensive efforts to increase access to LTCI in terms of availability, quality, cost, and information by collaborating with local centers.

Does Universal Health Insurance Act as a Driver of Increased Life Expectancy? Evidence from Selected Emerging Economies

Background: The world currently has experienced an unimaginable increase in life expectancy rate (LER). There are many factors that influence LER, including faith and forgiveness. However, an ongoing argument among scholars is whether health insurance is partly ascribed to the historical forces that drive the surge in LER among emerging countries. The study seeks to investigate the long-run effect of universal health insurance (UHI) on LER among 15 selected emerging countries spanning from 2000 to 2015. Methods: Using the panel unit root, panel cointegration, panel fully modified least squares (FMOLS), and employing the Dynamic ordinary least square (DOLS) as a robust check, the study analyzed connections between the study variables. Results: The outcome of the results showed that UHI, physician ratio, healthcare expenditure, and educational factors are positive contributors to increasing life expectancy, while economic growth remained negatively significant in the selected emerging economies. Conclusion: This study showed that improved education, increased physician ratio, increasing health expenditures, and universal insurance coverage were correlated with increased life expectancy in emerging economies. In order to promote healthy lives of its citizens, a move toward UHI coverage is suggested since it increases the life expectancy rate among emerging nations.

An Australian reflects on the Collings report 70 years on.

The publication of ‘General Practice in England Today — a Reconnaissance’ in the Lancet of 25 March 1950 made its Australian author, Dr Joseph Silver Collings, the National Health Scheme’s first whistleblower.1 It also ruined any chance of an academic or administrative career in the UK. Its unflattering description of English general practice angered the medical profession, particularly the British Medical Association (BMA). The Nuffield Provincial Hospital Trust who had funded it were not prepared to have their name associated with it. The Ministry of Health and the Chief Medical Officer who had directed the research underlying it remained silent. Joe Collings, as he preferred to be called, conducted the first evaluative research on general practice published in the English world.2 Challenging the smugness of British medicine, Collings was denied due recognition with his approach labelled unorthodox, and his sampling of English general practice considered fatally skewed. Joe was portrayed as a brash, inexperienced Australian influenced by American concepts with limited experience of British medicine. All those with direct knowledge of those times are now dead, so we must rely on records to ascertain what happened. Joe was a meticulous archivist and his wife Bett preserved his papers in the National Library of Australia.3 Extensive Rockefeller Foundation archive documents add to our knowledge of his activities.4 Joe had experienced general practice in two pioneering universal healthcare insurance systems, New Zealand and Manitoba, Canada, where the reformers sought his opinions. The Rockefeller Foundation funded him for 3 months in 1948 to explore medical educational developments in …

Essential Workflow and Performance Measures for Optimizing Acute Ischemic Stroke Treatment in India.

Essential Workflow and Performance Measures for Optimizing Acute Ischemic Stroke Treatment in India.

P1490MONTHLY TREND AND SEASONALITY IN ACUTE AND CHRONIC HEMODIALYSIS; RESULT FROM NATIONWIDE DATABASE OF MEDICAL BILLS OF UNIVERSAL HEALTH CARE INSURANCE SYSTEM IN JAPAN

Abstract Background and Aims Although knowing the accurate number of patients of hemodialysis important, data collection is a hard task. Establishing a simplified and prompt method of data collection for perspective hemodialysis is strongly needed. In Japan, there is a universal health care insurance system that covers almost all population. This study aimed to know a seasonal variation of hemodialysis patients using the big database of medical bills in Japan. Method Japanese Ministry of Health, Labour and Welfare established a big database named National Database (NDB), that consists of medical bills data in Japan. All bills data were sent to the data server from The Examination and Payment Agency, the organization that receives all medical bills from each medical institution and judge validity for payment. Each record of the database consists of bill data of one patient of a month for each medical institution. All data were anonymized before saved in the server and gave virtual patient identification number (VPID) that is unique for each patient. VPID is a hash value calculated by patient’s individual data such as name, date of birth, so that the value cannot be duplicate. Calculation of VPID is executed by an irreversible way to make it difficult to decrypt VPID into patient’s individual data. This database includes all information about medical care of whole population in Japan except for patients not under the insurance system (patients under public assistance system, victims of the war, or any other specified people under the public medical expense). Using this database, we investigated monthly number of patients who were recorded to be undergone hemodialysis (HD, includes hemodiafiltration). We searched chronic HD patients who have undergone HD on the month and continued it for 3 months, and acute HD patients who have discontinued HD within 3 months. Results In NDB, the number of chronic HD patients under public insurance system who confirmed to have undergone HD in December 2014 was 284 433. In contrast, the number of HD patients identified from the year-end survey by Japanese Society of Dialysis Therapy in the same year was of 311 193, but this number includes patients not under insurance system. Incidence rate of acute HD in Japan was persisted at 30-39 per million per month. There is a reproducible seasonal variation in number of acute HD patients, that increases in every winter and decreasing in every summer. The significantly highest frequency was observed in February(38.5/million/month) compared with September(30.6/million/month), the lowest month of the year (p<0.01). Conclusion We could show the trend in number of HD patients using nationwide bills data. Seasonality in some clinical factors in patients under chronic hemodialysis such as blood pressure, intradialytic body weight gain, morbidity of congestive heart failure, and, mortality, has been reported in many observational studies. Also, there are a few former reports about seasonality in AKI. However, a report about acute RRT is few. From our knowledge, this is the first report that revealed monthly dynamics of HD in a whole nation and rising risk of acute HD in winter. The true mechanism of this seasonality remains unclear. We have to establish a method to collect clinical data such as prevalence of CKD, causative diseases of AKI, kinds of precedent operations, and medications in connection with billing data.

Parkinson's disease and patient related outcomes in stroke: A matched cohort study

ObjectiveTo evaluate post-stroke outcomes in patients with Parkinson's disease (PD). MethodsA matched cohort study was performed. Stroke patients with PD and non-PD controls were extracted from the Thailand Universal Insurance Database. Logistic regressions were used to evaluate the association between PD and in-hospital outcomes (mortality and complications). The PD-associated long-term mortality was evaluated using Royston-Parmar models. ResultsA total of 1967 patients with PD were identified between 2003 and 2015 and matched to controls (1:4) by age, sex, admission year, and stroke type. PD patients had decreased odds of in-hospital death: OR (95% CI) 0.66 (0.52 – 0.84) and 0.61 (0.43 – 0.85) after ischaemic and haemorrhagic strokes, respectively. PD was associated with a length-of-stay greater than median (4 days) after both stroke types: 1.37 (1.21 – 1.56) and 1.45 (1.05 – 2.00), respectively. Ischaemic stroke patients with PD also had increased odds of developing pneumonia, sepsis and AKI: 1.52 (1.2 – 1.83), 1.54 (1.16 – 2.05), and 1.33 (1.02 – 1.73). In haemorrhagic stroke patients, PD was associated with pneumonia: 1.89 (1.31 – 2.72). Survival analyses showed that PD was protective against death in the short term (HR=0.66; 95% CI 0.53–0.83 ischaemic, and HR=0.50; 95% CI 0.37 – 0.68 haemorrhagic stroke), but leads to an increased mortality risk approximately 1 and 3 months after ischaemic and haemorrhagic stroke, respectively. ConclusionPD is associated with a reduced mortality risk during the first 2–4 weeks post-admission but an increased risk thereafter, in addition to increased odds of in-hospital complications and prolonged hospitalisation.

Chronic lung disease-associated PH: PAH-approved drugs and established universal healthcare insurance in Japan

Chronic lung disease-associated PH: PAH-approved drugs and established universal healthcare insurance in Japan

Impact of the 'Seguro Médico Siglo XXI' medical insurance programme on neonatal and infant mortality in Mexico, 2006-14: an ecological approach to estimation.

The 'Seguro Médico Siglo XXI' (SMSXXI), a universal coverage medical insurance programme for children under 5 years of age, started in 2006 to help avoid catastrophic health expenditures in poor families without social security in Mexico. The study used information from the National Health Information System for the 2006-14 period. An ecological approach was followed with a panel of the 2457 municipalities of Mexico as the units of analysis. The outcome variables were the municipality-level neonatal mortality and infant mortality rates in population without access to social security. The programme variable was the coverage of the SMSXXI programme at the municipality level, expressed as a proportion. Demographic and economic variables defined at the municipality level were included as covariates. Impact was estimated by fitting a fixed-effects negative binomial regression model. Results reveal that the SMSXXI significantly reduced both infant and neonatSal mortality in the target population, although in a non-linear fashion, with minimum mortality levels found around the 70% coverage range. The effect is mostly given by the transition from the first quintile to the fourth quintile of coverage (<13% vs 70.5-93.7% coverage), and it is attenuated significantly at coverage levels very close to or at 100%. The observed risk reduction amounted to an estimated total of 11 358 infant deaths being avoided due to the SMSXXI during the 2006-14 period, of which 48% were neonatal. In conclusion, we found a significant impact of the SMSXXI programme on both infant mortality and neonatal mortality. An attenuation of the effect of the insurance on mortality rates at levels close to 100% coverage may reflect the saturation of health units in detriment of the quality of care.

21 Racial Disparities in Outcomes After Burn Injury in a Universally Insured Military Population

Abstract Introduction In our healthcare system, racial disparities are estimated to account for more than 83,000 deaths and an average of more than $57 billion per year. These disparities have been well described in the surgical and trauma setting. Lack of insurance has frequently been blamed for the persistence of racial disparities in healthcare. The objective of the current study was to determine whether racial disparities in outcomes exist in a universally insured population of military-/civilian-dependent burn patients. Methods The 2006–2014 TRICARE military insurance database was queried for patients 18–64 years, who had a diagnosis of thermal burns. The Department of Defense Military Health System provides full insurance coverage for active/reserve/retired members of the Armed Services and their dependents. Basic demographic data and clinical characteristics were obtained. Our main outcome was in-hospital mortality. Multivariable logistic regression models were built to determine the association between race and the primary outcome. Results A total of 6,206 patients with diagnosis of burn injury were included: 69.7% white, 13.4% black, 6.8 % Hispanic, and 10% other. Median age was 29 years (IQR 23 - 40), and 63.1% were female. Overall mortality was 1.03%. In unadjusted analysis, there was no significant association between race and mortality (p=0.963). After multivariate analysis, no significant differences were found among racial minorities relative to racially white patients. Even though not significant, black patients had lower odds of mortality (OR 0.49, 95% CI 0.18 – 1.32) and Hispanic patients had higher odds (OR 1.33, 95% CI 0.39 – 4/52) when compared to white patients. Conclusions Risk-adjusted analysis did not show a significant difference in mortality among minority burn patients when compared to white patients. Our findings show that in a population with universal insurance and virtual equal access to care, racial disparities are mitigated. This data will help to the development of disparities interventions and its applicability nationwide. Applicability of Research to Practice The apparent mitigation of racial disparities among universally insured burn patients reinforces the association of insurance and access to care to outcomes in healthcare.