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How Did Safety Net Hospitals Cope in the 1990s?

Stephen Zuckerman, Gloria Bazzoli, Amy J. Davidoff, Anthony T. Lo Sasso

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Posted to Web: July 01, 2001

Permanent Link: http://www.urban.org/url.cfm?ID=1000330

This paper contrasts changes that took place among urban safety net hospitals (SNHs) during the period 1990 to 1997 with changes that occurred at other urban facilities. We use data from American Hospital Association Annual Survey and define three groups of SNHs based on 1990 provision of uncompensated care (UC): those that provided a large share of UC in their market; those for which UC imposed a burden because it represented a large share of their expenses; and those meeting both conditions. We found that, through 1997, high market share/high burden SNHs lost service volume relative to non-SNHs, but did not undertake reductions in staffing levels and expenses or reduce UC. High market share only hospitals were similar to non-SNHs, but reduced their UC market share and were more likely to enter into a merger. High burden only SNHs were most likely to close, but those that remained open experienced growth in volume and maintained their financial position. (Health Affairs 2001 July/August; 20(4):159-168)

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