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Med Care Res Rev. 2009 Oct;66(5):590-605. doi: 10.1177/1077558709334895. Epub 2009 Apr 27.

Understanding the safety net: inpatient quality of care varies based on how one defines safety-net hospitals.

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  • 1Health Research & Educational Trust, Chicago, IL 60606, USA.


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.

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