Organization and Financing of Indigent Hospital Care in South Florida

By Catherine A. Jackson; Amanda Beatty | Go to book overview

6
SUMMARY AND CONCLUSIONS

Among the three south Florida counties - Broward, Miami-Dade, and Palm Beach - a range of approaches is seen in the structure and financing of care for the indigent. Miami-Dade has a centralized local publicly funded system and many uninsured patients go to the county' s principal facility even when there are hospitals closer to their homes. Broward, both the North and South Districts, has a network of locally funded facilities throughout the county providing geographically convenient options for the uninsured. Palm Beach County uses its public funds to operate a managed care program for persons who would be otherwise uninsured. These different approaches to the financing and structures for indigent care provide a good opportunity to explore the effects on patients and hospitals.

In this report, we look at these issues from numerous perspectives, using several different sources of information. We conducted interviews and analyzed data that are reported to the state. Each information source provides a unique perspective and also bears its own limitations. For this reason, we are particularly interested in those results that are consistent across analyses. This section provides an overview of the findings as they relate to the initial questions motivating the report and identifies policy issues worthy of further consideration.

Before we review the specific findings, we want to set the context for interpretation. The three counties in south Florida that are the subject of this study - Broward, Miami-Dade, and Palm Beach - are different from one another along a number of dimensions: demographic, socioeconomic, and hospital-market.

Miami-Dade is the largest (in population and area), has the youngest population, and is the poorest county in south Florida. Palm Beach has an older population and is considerably wealthier. Broward County is between the two, both in its demographics and geographically.

The mix of tax-exempt, tax-paying, and tax-supported hospitals in the three counties affects the distribution of hospital bed resources. Broward County has nearly half of the hospital bed supply in tax-supported hospitals

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