Chatterjee Paula
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; email:
Annu Rev Public Health. 2025 Apr;46(1):525-539. doi: 10.1146/annurev-publhealth-071823-121237. Epub 2024 Oct 11.
The health care safety net provides essential clinical care and social services for low-income, uninsured, and underinsured populations in the United States. Despite these important functions, the health care safety net has experienced recurrent financial instability, growing market pressures, and workforce strain. Payment reform has also introduced unique challenges for safety net providers related to measuring and reaching quality benchmarks. A common theme among these challenges is that many of them result from applying standard health policy approaches to the safety net instead of using safety net-specific approaches. This review describes progress toward strengthening the safety net, key challenges, and opportunities moving forward.
医疗安全网为美国的低收入、未参保和保险不足人群提供基本的临床护理和社会服务。尽管发挥着这些重要作用,但医疗安全网仍反复面临财务不稳定、市场压力不断增大以及劳动力紧张等问题。支付改革也给安全网提供者带来了与衡量和达到质量基准相关的独特挑战。这些挑战的一个共同主题是,其中许多挑战是由于将标准的卫生政策方法应用于安全网,而不是采用针对安全网的特定方法造成的。本综述描述了加强安全网方面取得的进展、关键挑战以及未来的机遇。