Dr. Sharma rightly points out that the ability of our analysis to isolate the effects of race/ethnicity, insurance status, Spanish as a primary language, and safety-net vs private hospital setting are limited due to the collinearity of these factors in our patient population. Framing the issue another way, our safety-net facility is simultaneously a public hospital, a safety-net hospital, and a minority-serving hospital; and each of these factors likely contributes in varying degrees to an individual patient's outcomes. We do recognize that our study population reflects the unique circumstances of North Texas, with a high proportion of young and Hispanic patients and what amounts to a socialized indigent health care system (ie the government is both the payor and provider of care for the uninsured). Population and policy differences will likely lead to variations in different parts of the country and between rural and urban areas.
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        • Lasser KE
        • Liu Z
        • Lin M-Y
        • Paasche-Orlow MK
        • Hanchate A
        Changes in hospitalizations at US safety-net hospitals following medicaid expansion.
        JAMA Netw Open. 2021; 4e2114343
        • Figueroa JF
        • Zheng J
        • John Orav E
        • Epstein AM
        • Jha AK
        Medicare program associated with narrowing hospital readmission disparities between black and white patients.
        Health Aff. 2018; 37: 654-661
      1. Kaiser Family Foundation. Uninsured rates for the nonelderly by race/ethnicity. Available at: Accessed July 24, 2021.