在卫生服务研究文献中定义安全网医院：一项系统综述与批判性评价
Defining safety net hospitals in the health services research literature: a systematic review and critical appraisal.
作者信息
Hefner Jennifer L, Hogan Tory Harper, Opoku-Agyeman William, Menachemi Nir
机构信息
Division of Health Services Management and Policy, School of Public Health, The Ohio State University, Columbus, OH, USA.
School of Health and Applied Human Sciences, University of North Carolina at Wilmington, Wilmington, NC, USA.
出版信息
BMC Health Serv Res. 2021 Mar 25;21(1):278. doi: 10.1186/s12913-021-06292-9.
BACKGROUND
The aim of this study was to identify the range of ways that safety net hospitals (SNHs) have been empirically operationalized in the literature and determine the extent to which patterns could be identified in the use of empirical definitions of SNHs.
METHODS
We conducted a PRISMA guided systematic review of studies published between 2009 and 2018 and analyzed 22 articles that met the inclusion criteria of hospital-level analyses with a clear SNH definition.
RESULTS
Eleven unique SNH definitions were identified, and there were no obvious patterns in the use of a definition category (Medicaid caseload, DSH payment status, uncompensated care, facility characteristics, patient care mix) by the journal type where the article appeared, dataset used, or the year of publication.
CONCLUSIONS
Overall, there is broad variability in the conceptualization of, and variables used to define, SNHs. Our work advances the field toward the development of standards in measuring, operationalizing, and conceptualizing SNHs across research and policy questions.
背景
本研究的目的是确定安全网医院（SNHs）在文献中已被实证应用的方式范围，并确定在使用SNHs实证定义时能够识别出模式的程度。
方法
我们对2009年至2018年发表的研究进行了PRISMA指导的系统评价，并分析了22篇符合医院层面分析纳入标准且有明确SNH定义的文章。
结果
确定了11种独特的SNH定义，并且在文章发表的期刊类型、所使用的数据集或出版年份方面，在使用定义类别（医疗补助病例量、DSH支付状态、未补偿医疗、机构特征、患者护理组合）方面没有明显模式。
结论
总体而言，SNHs的概念化以及用于定义的变量存在广泛差异。我们的工作推动该领域朝着跨研究和政策问题衡量、实施和概念化SNHs的标准发展。
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