(Reuters Health) – In an emergency involving face or hand trauma, barely one in four hospitals can muster a specialist surgeon, a recent U.S. study suggests.

In a survey of hospitals in New York State, excluding those in New York City, researchers found that only 27% had hand surgeons available or on call for emergency hand procedures and 29% had plastic surgeons available for facial emergencies.

โ€œAlthough more people have insurance now, it doesnโ€™t guarantee access, especially in areas with geographic barriers,โ€ said senior study author Dr. Ashit Patel, the chief of plastic surgery at Albany Medical College.