To examine the effects of safety net hospital () closure and for‐profit conversion on uninsured, , and racial/ethnic minorities.
Data Sources/Extraction Methods
Hospital discharge data for selected states merged with other sources.
We examined travel distance for patients treated in urban hospitals for five diagnosis categories: ambulatory care sensitive conditions, referral sensitive conditions, marker conditions, births, and mental health and substance abuse. We assess how travel was affected for patients after events. Our multivariate models controlled for patient, hospital, health system, and neighborhood characteristics.
Our results suggested that certain groups of uninsured and patients experienced greater disruption in patterns of care, especially uninsured and women hospitalized for births. In addition, relative to privately insured individuals in event communities, greater travel for mental health and substance abuse care was present for the uninsured.
Closure or for‐profit conversions of s appear to have detrimental access effects on particular subgroups of disadvantaged populations, although our results are somewhat inconclusive due to potential power issues. Policy makers may need to pay special attention to these patient subgroups and also to easing transportation barriers when dealing with disruptions resulting from reductions in resources.
