Variation, Overlap, and Stability in Defining Safety Net Hospitals

To what extent do different definitions for safety net hospitals overlap, change over time, and represent similar types of facilities?In this cohort study of 4531 short-term acute care hospitals, between 1% and 55% of similar hospitals were represented across pairs of definitions, with some definitions producing different samples of hospitals year to year. Different definitions produced different groups of hospitals over time, risking overinclusion and/or underinclusion of certain hospitals across different payment programs.The findings highlight the trade-offs when considering options to define safety net hospitals.

Corresponding Author: Paula Chatterjee, MD, MPH, University of Pennsylvania, 423 Guardian Dr, Room 1318, Philadelphia, PA 19104 (pchat@pennmedicine.upenn.edu).

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