Journal Article

Defining safety net hospitals in the health services research literature: a systematic review and critical appraisal

Opoku-Agyeman, William, Hogan, Tory Harper, Menachemi, Nir, Hefner, Jennifer L.

2021

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Central service department / Data analysis / Disparities / Health Administration / Health care / Health care access / Health Informatics / Health services / Health Services Research / Health systems and services in low and middle income settings / Hospitals / Humans / Indigent care / Medicaid / Medical care / Medicine / Medicine & Public Health / Nursing Research / Patient safety / Public Health / Research Article / Research methodology / Safety net providers / Systematic review / Uninsured people / United States / Utilization / Variables