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Table 1 Description of included articles (n = 22)

From: Defining safety net hospitals in the health services research literature: a systematic review and critical appraisal

Variables Frequency (%)
Publication Year
 2009–2012 6 (27%)
 2013–2015 7 (32%)
 2016–2018 9 (41%)
Journal Type
 Health Services journals 10 (45%)
 Policy journals 7 (32%)
 Clinical journals 5 (23%)
Data Sourcea
 American Hospital Association (AHA) 13 (59%)
 Medicare Cost Reports 6 (27%)
 Health Care Utilization Project (HCUP) and other inpatient discharge databases 5 (23%)
 National Inpatient Sample (NIS) 2 (9%)
 Virginia Health Information discharge data 1 (5%)
 CA Office of Statewide health planning and development (OSHPD) 1 (5%)
 Agency for Healthcare Research Socioeconomic Status Index 1 (5%)
 Centers for Medicare and Medicaid Services Impact File 1 (5%)
Five category classification systema
 Medicaid Caseload 13 (59%)
 Disproportionate Share (DSH) payments 8 (36%)
 Uncompensated care 7 (32%)
 Facility characteristics 5 (23%)
 Patient case mix 2 (9%)
Outcome of focus among included studiesa
 Quality 17 (77%)
 Cost 8 (36%)
 Access 2 (9%)
Inclusion of a source or rationale for SNH definition
 Accompanying reference was cited 17 (77%)
 Definition choice was justified with supporting text 12 (55%)
 Authors noted the variety of SNH definitions in the literature. 11 (50%)
  1. aSome articles included more than one definition of SNH, more than one dataset, and/or focused on more than one outcome. Thus, sums do not add up to 100%