A new study shows that trauma patients without health insurance are twice as likely to die in the hospital as those with insurance, according to the Associated Press.

Doctors and health experts, who thought emergency room treatment was fair and unprejudiced, were shocked to hear the news from the Harvard University researchers.

"This is another drop in a sea of evidence that the uninsured fare much worse in their health in the United States," said senior author Dr. Atul Gawande, a Harvard surgeon and medical journalist.

Published in the November issue of Archives of Surgery, the study is just in time to add fuel to the debate in Congress over extending health insurance coverage to the millions of uninsured in America.

Researchers were not able to determine the reasons behind the discrepancies. They found that the uninsured might have a longer wait when being transferred between hospitals, they may get different care altogether, and they may experience greater difficulty communicating with doctors.

The hospitals treating the uninsured may also have fewer resources.

"Those hospitals tend to be financially strapped, not have the same level of staffing, not have the same level of surgeons and testing and equipment," Gawande said. "That also is likely a major contributor."

Gawande supports the health care reform and has written about the inequality of the current system several times.

The researchers took into account the seriousness of the injuries sustained, along with the patients' race, gender and age were taken into consideration. But even after such adjustments, the researchers still found that the uninsured had an 80 percent greater risk of dying than those with insurance or even low-income patients covered by the government's Medicaid program.

"I'm really surprised," said Dr. Eric Lavonas of the American College of Emergency Physicians and a doctor at Denver Health Medical Center. "It's well known that people without health insurance don't get the same quality of health care in this country, but I would have thought that this group of patients would be the least vulnerable."

Lavonas, who spoke independent of the study said that some private hospitals are more apt to transfer an uninsured patient than an insured patient.

"Sometimes we get patients transferred and we suspect they're being transferred because of payment issues," he said. "The transferring physician says, 'We're not able to handle this.'"

Hospital emergency rooms are required by federal law to treat all medically unstable patients. However, hospitals can still transfer or send patients away after they are stabilized, which could worsen a patient's condition by delaying treatment.

The researchers evaluated data on about 690,000 U.S. patients from 2002 through 2006. They did not include burn patients, those treated and released, or dead on arrival.

The researchers found that the overall death rate was 4.7 percent, meaning that the majority of emergency room patients survived their injuries. Those who were commercially insured had a death rate of 3.3 percent, while the uninsured patients' death rate was 5.7 percent. Those rates were determined before the adjustments for other risk factors.

The findings are based on an analysis of data from the National Trauma Data Bank, which has over 900 U.S. hospitals.

"We have to take the findings very seriously," said lead author Dr. Heather Rosen, a surgery resident at Los Angeles County Hospital, who found comparable results when she analyzed children's trauma data for a previous study. "This affects every person, of every age, of every race."