Increasing the percentage of community residents who have health coverage may improve care for all residents.

Mark Pauly and Jose Pag?n make that suggestion in a study that appears in the September-October issue of the journal Health Affairs.

The economists looked at health access, use and quality indicators for 9,552 insured adults in 10 communities with a high percentage of uninsured adults and in 10 communities with a low percentage of uninsured adults.

The average rate of uninsurance was 27% in the poorly insured communities and 7% in the well-insured communities.

Insured residents in the poorly insured communities were less likely than insured residents in the well-insured communities to have a place to go when they were sick or needed health care advice, less likely to visit a doctor, and less likely to have had a physician exam within the last year, the economists found.

Insured residents in poorly insured communities also reported more problems getting referred to a specialist and were less likely to report that they were satisfied with their doctors, the economists report

Pauly and Pag?n also looked at physician survey data and found that doctors in poorly insured communities were unhappier about their careers and less confident about their ability to refer patients to good specialists.