The resilience of the health care safety net, 1996-2001.
Objective: To determine how the capacity and viability of local health care safety nets changed over the last six years and to draw lessons from these changes.Data Source: The first three rounds (May 1996 to March 2001) of Community Tracking Study site visits to 12 communities.Study Design: Research...
| Publicado en: | Health Services Research Vol. 38; no. 1; pp. 489 - 503 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Feb2003
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106653902&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106653902 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00179124 HSR jtl: Health Services Research issn: 00179124 maglogo: Y pubinfo: dt: Feb2003 vid: 38 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106653902 106653902 NLM12650377 2004168001 10.1111/1475-6773.00126 NLM12650377 106653902 ppf: 489 ppct: 14 formats: tig: atl: The resilience of the health care safety net, 1996-2001. aug: au: Felland LE Lesser CS Staiti AB Katz A Lichiello P Felland, Laurie E Lesser, Cara S Staiti, Andrea Benoit Katz, Aaron Lichiello, Patricia affil: Center for Studying Health System Change, Washington, DC 20024, USA sug: subj: Health Care Delivery Trends Health Policy Health Services Accessibility Trends Medically Uninsured Data Analysis Software Descriptive Statistics Health and Welfare Planning Health Services Research Managed Care Programs Medicaid Medicare Poverty Prospective Studies Semi-Structured Interview Socioeconomic Factors Thematic Analysis Uncompensated Care United States Funding Source Human ab: Objective: To determine how the capacity and viability of local health care safety nets changed over the last six years and to draw lessons from these changes.Data Source: The first three rounds (May 1996 to March 2001) of Community Tracking Study site visits to 12 communities.Study Design: Researchers visited the study communities every two years to interview leaders of local health care systems about changes in the organization, delivery, and financing of health care and the impact of these changes on people. For this analysis, we collected data on safety net capacity and viability through interviews with public and not-for-profit hospitals, community health centers, health departments, government officials, consumer advocates, academics, and others. We asked about the effects of market and policy changes on the safety net and how the safety net responded, as well as the impact of these changes on care for the low-income uninsured.Principal Findings: The safety net in three-quarters of the communities was stable or improved by the end of the study period, leading to improved access to primary and preventive care for the low-income uninsured. Policy responses to pressures such as the Balanced Budget Act and Medicaid managed care, along with effective safety net strategies and supportive conditions, helped reinforce the safety net. However, the safety net in three sites deteriorated and access to specialty services remained inadequate across the 12 sites.Conclusions: Despite pessimistic predictions and some notable exceptions, the health care safety net grew stronger over the past six years. Given considerable community variation, however, this analysis indicates that policymakers can apply a number of lessons from strong and improving safety nets to strengthen those that are weaker, particularly as the current economy poses new challenges. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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