Felland Laurie E, Cunningham Peter J, Cohen Genna R, November Elizabeth A, Quinn Brian C
Res Brief. 2010 Jan(15):1-8.
While the recession increased demands on the health care safety net as Americans lost jobs and health insurance, the impact on safety net providers has been mixed and less severe--at least initially--than expected in some cases, according to a new study of five metropolitan communities by the Center for Studying Health System Change (HSC). Even before the recession, many safety net providers reported treating more uninsured patients and facing tighter state and local funding. Federal expansion grants for community health centers during the past decade, however, have increased capacity at many health centers. And, programs to help direct people to primary care providers may have helped stem the expected surge in emergency department use by the uninsured during the downturn. Federal stimulus funding--the 2009 American Recovery and Reinvestment Act--has assisted hospitals and health centers in weathering the economic storm, helping to offset reductions in state, local and private funding. And, the economic downturn has generated some potential benefits, including lower rents and broader employee applicant pools. While safety net providers have adopted strategies to stay financially viable, many believe they have not yet felt the full impact of the deepest recession since the Great Depression.
根据医疗体系变革研究中心（HSC）对五个大都市社区的一项新研究，随着美国人失业并失去医疗保险，经济衰退增加了对医疗安全网的需求，不过，至少在某些情况下，对安全网提供者的影响好坏参半，且没有预期的那么严重。甚至在经济衰退之前，许多安全网提供者就报告称治疗的 uninsured 患者增多，且面临州和地方资金收紧的情况。然而，过去十年联邦对社区健康中心的扩张拨款增加了许多健康中心的服务能力。此外，帮助引导人们前往初级保健提供者处就诊的项目可能有助于阻止经济低迷期间 uninsured 人群急诊室就诊人数预期的激增。联邦刺激资金——2009年的《美国复苏与再投资法案》——帮助医院和健康中心度过了经济风暴，有助于抵消州、地方和私人资金的减少。而且，经济衰退也产生了一些潜在好处，包括租金降低和求职者范围扩大。虽然安全网提供者已采取策略来维持财务上的可行性，但许多人认为他们尚未感受到自大萧条以来最严重衰退的全部影响。
