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