Understanding the safety net: inpatient quality of care varies based on how one defines safety-net hospitals.
A challenge to investigating quality of care at safety-net hospitals is the absence of a standard method for identifying these hospitals. The authors identified three different, commonly used approaches for classifying hospitals as safety-net providers. Analyzing national data on hospital demographics and quality of care, they found little overlap among these three sets of hospitals. Under two definitions, safety-net providers clearly underperformed on quality compared with non-safety-net providers; under a third definition, results were mixed. How one defines safety-net providers can affect health services research outcomes and policy recommendations.
McHugh
Megan
M
Health Research & Educational Trust, Chicago, IL 60606, USA. mmchugh@aha.org
Kang
Raymond
R
Hasnain-Wynia
Romana
R
D000573:American Hospital Association; D003625:Data Collection; D006761:Hospitals / Q000592:standards*; D006779:Hospitals, Public / Q000592:standards; D006784:Hospitals, Teaching / Q000592:standards; D006786:Hospitals, Urban / Q000592:standards; D006801:Humans; D007297:Inpatients; D008484:Medicaid / Q000706:statistics & numerical data; D011787:Quality of Health Care; D012449:Safety; D014481:United States