TY  - JOUR
PY  - 2015//
TI  - Survival rates in trauma patients following health care reform in Massachusetts
JO  - JAMA surgery
A1  - Osler, Turner
A1  - Glance, Laurent G.
A1  - Li, Wenjun
A1  - Buzas, Jeffery S.
A1  - Hosmer, David W.
SP  - 609
EP  - 615
VL  - 150
IS  - 7
N2  - 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>
LA  - en
SN  - 2168-6254
UR  - http://dx.doi.org/10.1001/jamasurg.2014.2464
ID  - ref1
ER  -