Abstract
Safety-net hospitals are experiencing increasing financial strains, possibly affecting their quality of care. We compare quality at safety-net and non-safety-net urban hospitals for Medicare beneficiaries admitted with acute myocardial infarction (AMI). Although safety-net hospitals had modestly higher risk-standardized thirty-day all-cause mortality rates and modestly lower adherence to quality-of-care performance measures than non-safety-net hospitals, there was much heterogeneity among safety-net hospitals and substantial overlap with non-safety-net hospitals. We examine the implications of these findings for the millions of vulnerable Americans who rely on safety-net hospitals for their care.
Publication types
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Research Support, Non-U.S. Gov't
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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Acute Disease
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Aged
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Aged, 80 and over
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Female
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Health Care Surveys
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Health Services Accessibility / economics*
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Hospital Mortality
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Hospitals, Urban / classification
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Hospitals, Urban / economics
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Hospitals, Urban / standards*
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Humans
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Male
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Medicare / legislation & jurisprudence
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Medicare / standards*
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Myocardial Infarction / economics
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Myocardial Infarction / mortality
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Myocardial Infarction / therapy*
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Patient Admission / statistics & numerical data
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Patient Transfer / statistics & numerical data
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Prospective Payment System / legislation & jurisprudence
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Quality of Health Care / statistics & numerical data*
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Reimbursement, Disproportionate Share / legislation & jurisprudence*
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Retrospective Studies
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Risk Assessment
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United States / epidemiology
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Vulnerable Populations*