Safety nets provide quality care despite financial burdens

Although safety-net hospitals face financial pressures to treat large numbers of uninsured and low-income patients, quality of care doesn't suffer, according to a study published in the August Health Affairs.

Analyzing acute myocardial infarction, heart failure or pneumonia patients hospitalized between Jan. 1, 2006, and Dec. 31, 2008, researchers found comparable mortality and readmission rates for safety-nets and non-safety-net hospitals. Both types of hospitals saw identical heart failure mortality rates.

"We were surprised to find that mortality and readmission rates were broadly similar across urban areas for both safety-net and non-safety-net hospitals with differences, on average, of less than one percentage point across these three conditions," study author Joseph S. Ross, assistant professor of internal medicine at Yale School of Medicine, said Monday in a statement.

The findings reinforce calls to expand Medicaid programs as allowed under health reform to maintain quality care for underserved patients.

"By expanding insurance coverage, the newly enacted healthcare law should help safety-net hospitals attain even lower readmission and mortality rates," noted study author Elizabeth E. Drye, director of quality measurement programs at the Yale Center for Outcomes Research and Evaluation.

Although there's no difference in quality of care between safety-net hospitals and non-safety nets, a July study published in the Archives of Internal Medicine found a disparity in patient ratings. In fact, safety nets scored lower than other hospitals on almost every measure of patient experience than other hospitals.

For more:
- read the study abstract
- here's the research announcement