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In This Issue of JAMA Surgery
July 2015


JAMA Surg. 2015;150(7):601. doi:10.1001/jamasurg.2014.2513

Health care reform (HCR) in Massachusetts was expected to expand insurance coverage and improve outcomes, but the effect of HCR on patients with traumatic injuries had not been studied. In a retrospective cohort study of patients hospitalized following traumatic injury in Massachusetts or New York during the 10 years (2002-2011) surrounding Massachusetts HCR, Osler et al assessed the effect of HCR on mortality rates using data from the State Inpatient Databases and a difference-in-differences approach to control for temporal trends in mortality. Surprisingly, HCR did not affect health insurance coverage for patients hospitalized following injury but was associated with a transient increase in adjusted mortality rates. Simply promoting health insurance coverage through legislation does not improve survival after injury.