Zwanziger Jack, Khan Nasreen
University of Illinois at Chicago.
Med Care Res Rev. 2008 Aug;65(4):478-95. doi: 10.1177/1077558708315440.
Vulnerable populations, who have difficulty accessing the health care system, primarily receive their medical care from hospitals. Policy makers have struggled to ensure the survival of "safety-net hospitals," hospitals that provide a disproportionate share of care to these patient populations. The objective of this article is to develop measures to guide analysis and policy for urban safety-net hospitals. The authors developed three safety-net measures: the socioeconomic status of hospital service area, Medicaid intensity, and uncompensated care burden and its market share. Cluster analysis was used to identify break points that distinguish a safety-net hospital from a non-safety-net hospital. The measures developed were stable and independent, but a data-driven binary assignment of hospitals to a "safety-net" category was not supported. These analyses call into question the empirical basis for distinguishing a specific group of hospitals as safety-net hospitals.
弱势群体难以获得医疗保健系统的服务，主要从医院接受医疗护理。政策制定者一直在努力确保“安全网医院”的生存，这些医院为这些患者群体提供了不成比例的护理份额。本文的目的是制定措施，以指导对城市安全网医院的分析和政策制定。作者制定了三项安全网衡量标准：医院服务区的社会经济地位、医疗补助强度、未补偿护理负担及其市场份额。聚类分析用于确定区分安全网医院和非安全网医院的断点。所制定的衡量标准是稳定且独立的，但不支持基于数据将医院二元划分为“安全网”类别。这些分析对将特定一组医院区分为安全网医院的实证基础提出了质疑。
