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Does the patient's payer matter in hospital patient safety?: a study of urban hospitals.
Clement JP, Lindrooth RC, Chukmaitov AS, Chen HF. Med Care. 2007;45:131-138.

This study explores the link between financial reimbursement and patient safety by examining the effect of changes in reimbursement policies and performance on the Agency for Healthcare Research and Quality's Patient Safety Indicators (PSIs). The investigators attempted to control for other factors affecting PSI rates, including nurse-staffing ratios and patient characteristics. Results varied across different payers; decreased Medicare and private insurance reimbursements were associated with worsened patient safety, but changes in Medicaid reimbursement did not have the same effect. While this analysis is preliminary, it may have implications for the burgeoning pay-for-performance movement.

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