@article{ref1,
title="Survival rates in trauma patients following health care reform in Massachusetts",
journal="JAMA surgery",
year="2015",
author="Osler, Turner and Glance, Laurent G. and Li, Wenjun and Buzas, Jeffery S. and Hosmer, David W.",
volume="150",
number="7",
pages="609-615",
abstract="IMPORTANCE: Massachusetts introduced health care reform (HCR) in 2006, expecting to expand health insurance coverage and improve outcomes. Because traumatic injury is a common acute condition with important health, disability, and economic consequences, examination of the effect of HCR on patients hospitalized following injury may help inform the national HCR debate. <br><br>OBJECTIVE: To examine the effect of Massachusetts HCR on survival rates of injured patients. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 1 DESIGN, SETTING, AND PARTICIPANTS:  520 599 patients hospitalized following traumatic injury in Massachusetts or New York during the 10 years (2002-2011) surrounding Massachusetts HCR using data from the State Inpatient Databases. We assessed the effect of HCR on mortality rates using a difference-in-differences approach to contr DESIGN, SETTING, AND PARTICIPANTS: ol for temporal trends in mortality. INTERVENTION: Health care reform in Massachusetts in 2006. MAIN OUTCOME AND MEASURE: Survival until hospital discharge. <br><br>RESULTS: During the 10-year study period, the rates of uninsured trauma patients in Massachusetts decreased steadily from 14.9% in 2002 to 5.0.% in 2011. In New York, the rates of uninsured trauma patients fell from 14.9% in 2002 to 10.5% in 2011. The risk-adjusted difference-in-difference assessment revealed a transient increase of 604 excess deaths (95% CI, 419-790) in Massachusetts in the 3 years following implementation of HCR. <br><br>CONCLUSIONS AND RELEVANCE: Health care reform did not affect health insurance coverage for patients hospitalized following injury but was associated with a transient increase in adjusted mortality rates. Reducing mortality rates for acutely injured patients may require more comprehensive interventions than simply promoting health insurance coverage through legislation.<p /> <p>Language: en</p>",
language="en",
issn="2168-6254",
doi="10.1001/jamasurg.2014.2464",
url="http://dx.doi.org/10.1001/jamasurg.2014.2464"
}