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Vulnerable populations, who have difficulty accessing the health care system, primarily receive their medical care from hospitals. Policy makers have struggled to ensure the survival of "safety-net hospitals," hospitals that provide a disproportionate share of care to these patient populations. The objective of this article is to develop measures to guide analysis and policy for urban safety-net hospitals. The authors developed three safety-net measures: the socioeconomic status of hospital service area, Medicaid intensity, and uncompensated care burden and its market share. Cluster analysis was used to identify break points that distinguish a safety-net hospital from a non-safety-net hospital. The measures developed were stable and independent, but a data-driven binary assignment of hospitals to a "safety-net" category was not supported. These analyses call into question the empirical basis for distinguishing a specific group of hospitals as safety-net hospitals.

Paper prepared for the 2nd International Research Conference on Social Security Jerusalem, 25-28 January 1998 ; 'Safety net' is regarded as the bottom-line of social welfare. Its establishment in Western democracies aims at providing citizens and families with basic means that guarantee the satisfaction of minimum vital needs and facilitate social integration. In Southern Europe (Greece, Italy, Portugal, and Spain) the building up of nets of social assistance is highly conditioned by the nature of its welfare development and institutional peculiarities. Four elements can be underlined in this respect: (a) Fragmented social protection of an occupational nature; (b) A type of family in which women carry out a pivotal role for assistance and care; (c) A particularist distribution of welfare resources and fiscal transfers; and (d) An increasing role for the 'third sector' in the provision of social services. The paper looks at issues regarding the targeting of the poor, the 'Mathew effect', the Southern family, and the implementation of minimum income programmes for the excluded and poor in decentralised Spain. ; Peer reviewed

The failure to effectively target federal safety-net funding for hospitals has, for decades, lowered the quality of care and outcomes for safety-net patients, particularly for those of color. That's according to LDI Senior Fellow and Perelman School of Medicine's Paula Chatterjee, MD, MPH, writing in a recent JAMA Health Forum Viewpoint focused on the Medicaid […]

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This article evaluates the rapid escalation of American household debt in relation to the changing dynamics of liberal welfare capitalism. Starting with the outcome of rising household debt levels during the credit and asset bubble of 2001–7 it argues that the failure of asset‐based welfare and the inability of households to move beyond their historical dependence on earned income made indebtedness essential to household social participation and protection. It examines the unique relationship of young adults (households headed by persons under age 35) and senior citizens (households headed by persons over age 65) to the liberal welfare regime, in particular the ways in which these relationships were shaped by the 2001–7 credit and asset bubble. By using a framework in which debt is analyzed as a claim against income, alongside other costs of social participation and daily living, we see the impact of the credit and asset boom on both young adults and senior citizens: growing indebtedness and financial insecurity.