Trends: An update on safety-net hospitals: Coping with the late 1990s and early 2000s

Health Affairs

Volumn 24, Issue 4, 2005, Pages 1047-1056

  Bazzoli, Gloria J ^a   Kang, Ray ^b   Hasnain Wynia, Romana ^b   Lindrooth, Richard C ^c  

^a VIRGINIA COMMONWEALTH UNIVERSITY   (United States)

^b Health Research and Educational Trust   (United States)

^c MEDICAL UNIVERSITY OF SOUTH CAROLINA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CLASSIFICATION; COMMUNITY CARE; COMPARATIVE STUDY; ECONOMICS; EPIDEMIOLOGY; FINANCIAL MANAGEMENT; FORECASTING; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HOSPITAL; HOSPITAL MANAGEMENT; HUMAN; MEDICAL SOCIETY; NON PROFIT HOSPITAL; ORGANIZATION AND MANAGEMENT; PUBLIC HOSPITAL; STATISTICS; UNITED STATES; UTILIZATION REVIEW;

AMERICAN HOSPITAL ASSOCIATION; FINANCIAL MANAGEMENT, HOSPITAL; FORECASTING; HEALTH CARE SECTOR; HEALTH CARE SURVEYS; HEALTH POLICY; HEALTH SERVICES ACCESSIBILITY; HOSPITALS; HOSPITALS, PROPRIETARY; HOSPITALS, PUBLIC; HOSPITALS, VOLUNTARY; HUMANS; OWNERSHIP; PRODUCT LINE MANAGEMENT; UNCOMPENSATED CARE; UNITED STATES;

EID: 23044468182     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.24.4.1047     Document Type: Article

References (33)

1. In particular, P.J. Cunningham and H.T. Tu, "A Changing Picture of Uncompensated Care," Health Affairs 16, no. 4 (1997): 167-175, noted that there were three major components of the health care safety net: general acute care hospitals, community health centers, and private physicians.
2. M.S. Marquis, J.A. Rogowski, and J.J. Escarce, "Recent Trends in Geographic Variation in the Safety Net," Medical Care 42, no. 5 (2004): 408-415, also identified hospitals as one of the five core components of local safety nets.
3. Institute of Medicine, America's Safety Net: Intact but Endangered (Washington: National Academies Press, 2000).
4. S. Zuckerman et al., "How Did Safety-Net Hospitals Cope in the 1990s?" Health Affairs 20, no. 4 (2001): 159-168.
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11. Financial Data Report Ibid.;
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19. Baxter and Mechanic, "The Status of Local Health Care Safety Nets";
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21. B.H. Gray, "Hospital Ownership Form and Care of the Uninsured," in The Future of the U.S. Healthcare System: Who Will Care for the Poor and Uninsured? ed. S.H. Altman, U.E. Reinhart, and A.E. Shields (Chicago: Health Administration Press, 1998), 207-222;
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23. Many researchers have examined uncompensated rather than just charity care when examining hospital involvement in the safety net. Largely, this is due to issues raised by T.G. Rundall, S. Sofaer, and W. Lambert, "Uncompensated Hospital Care in California," in Advances in Health Economics and Health Services Research, vol. 9, ed. R. Scheffler and L.F. Rossiter (Stamford, Conn.: JAI Press, 1988), 113-133. Rundall and colleagues noted that differences across hospitals in the definitions and accounting practices for charity care and bad-debt expenses make it difficult to distinguish these two concepts with validity.
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25. Specifically, to derive a value of uncompensated care for hospitals with missing values, we used a prediction from a regression model that included market demographics, hospital market characteristics, hospital characteristics, and a series of state indicators as independent variables. These regressions were estimated separately for for-profit, voluntary nonprofit, and public hospitals.
26. D. Gaskin, Safety Net Hospitals: Essential Providers of Public Health and Specialty Services (New York: Commonwealth Fund, February 1999).
27. It is interesting to note that fewer Group 4 hospitals provided maternity services, as noted in Exhibit 3, but those that continued the service as reported in Exhibit 4 experienced large increases in the number of births.
28. Zuckerman et al., "How Did the Safety Net Hospitals Cope in the 1990s?"
29. Office of Management and Budget, "FY 2006 Budget Priorities: Department of Health and Human Services," December 2004, www.whitehouse.gov/omb/budget/fy2006/hhs.html (12 April 2005).
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32. and P. Cunningham, "Insured Americans Drive Surge in Emergency Room Use," Issue Brief no. 70 (Washington: HSC, October 2003), 1-6.
33. OMB, "FY 2006 Budget Priorities."