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Mass. insurance mandate got trauma patients into rehab faster, research says

Patient record form with stethoscope
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New data on how patients fared at one Massachusetts trauma center following the state's passage of a universal health care law may shed some light on what may be expected under Obamacare, according to the study's lead author.

In 2007, Massachusetts implemented a health care law that required all residents to get insurance. It served in some ways as a model for the 2010 Affordable Care Act, or Obamacare, which has an individual insurance mandate beginning January 1, 2014, requiring most Americans to get health insurance or face an IRS fine.

Online marketplaces opened this weekto allow Americans to start signing up for health insurance under the new program.

There's been an increase in research results coming out of Massachusetts that compares health care before and after the state's law passed, which could serve as a sign of things to come nationwide, according to study author Dr. Jarone Lee.

"We can look at it a lot closer now," Lee, an emergency medicine specialist who serves as quality director of surgical critical care at Massachusetts General Hospital in Boston, said to CBSNews.com.

The new study of trauma patients at Mass. General Hospital has yet to be published or even presented at a medical conference, but the data was provided to CBS News in advance of its Oct. 14 release by the American College of Emergency Physicians.

For the study, researchers looked back at medical records collected from Jan. 2004 to Dec. 2012, to examine differences in patients' health outcomes before and after the 2007 passage. They specifically looked at whether the insurance mandate had an impact on length of stay in the ICU, death rates, overall length of hospital stay, and when patients were getting discharged to home services like a rehabilitation facility.

The study only looked at serious trauma patients, like those who got shot or stabbed or were involved in a motor vehicle accident. But Lee said that trauma care studies often serve as a good proxy of how hospitals utilize their resources.

Traditionally, uninsured trauma patients -- who tend to be younger individuals -- fare worse than their insured counterparts, Lee said, so the researchers thought they might see the greatest impact following the mandate in these patients.

What they found were no statistically significant differences in length of stay at the ICU or in death rates before and after the mandate. Statistical significance means the researchers can't rule out that any differences in findings were due to chance.

On the surface that suggests the new law's passage didn't save more lives, as the researchers had expected.

"It's not really a negative finding, but we were thinking we'd see a decrease in mortality that we didn't see," he said. "On the flip-side, it shows we're giving them the same amount of care before and after at our hospital."

Another finding was that the average total length of hospital stays dropped from about 13 days to 11 days. Patients were more likely to be discharged home to receive services, like rehab, sooner after the mandate than before.

Uninsured trauma patients may otherwise spend those days waiting around for a placement in a charity-sponsored care service. These extra two or three days could go a long way in getting someone back to their daily lives, Lee said, and may ultimately reduce societal health care costs, such as those stemming from missed time off work. That kind of data may take 20 years to see results, he added.

The results are considered preliminary since they've yet to be published, and Lee acknowledged a major limitation of his study is it only looked at one hospital in Massachusetts; more research is planned, looking at other hospitals in the state.

But Lee says he's seen the effects of the law firsthand.

"I think the insurance mandate is working and we get them home faster, less work is lost, (they have) more improved quality of life," said Lee. "I think it's great because a lot of these folks who are uninsured, might get stuck in the hospital, and that's not the best place for them."