Hospital Partnerships for Population Health: A Systematic Review of the Literature

Abstract

EXECUTIVE SUMMARY The U.S. healthcare system continues to experience high costs and suboptimal health outcomes that are largely influenced by social determinants of health. National policies such as the Affordable Care Act and value-based payment reforms incentivize healthcare systems to engage in strategies to improve population health. Healthcare systems are increasingly expanding or developing new partnerships with community-based organizations to support these efforts. We conducted a systematic review of peer-reviewed literature in the United States to identify examples of hospital–community partnerships; the main purposes or goals of partnerships; study designs used to assess partnerships; and potential outcomes (e.g., process- or health-related) associated with partnerships. Using robust keyword searches and a thorough reference review, we identified 37 articles published between January 2008 and December 2019 for inclusion. Most studies employed descriptive study designs (n = 21); health needs assessments were the most common partnership focus (n = 15); and community/social service (n = 21) and public health organizations (n = 15) were the most common partner types. Qualitative findings suggest hospital–community partnerships hold promise for breaking down silos, improving communication across sectors, and ensuring appropriate interventions for specific populations. Few studies in this review reported quantitative findings. In those that did, results were mixed, with the strongest support for improvements in measures of hospitalizations. This review provides an initial synthesis of hospital partnerships to address population health and presents valuable insights to hospital administrators, particularly those leading population health efforts.

Exploring the Role of Community Social Capital in Not-for-profit Hospitals’ Decision to Engage Community Partners in the Community Health Needs Assessment Process

“…While hospitals commonly cooperate formally with local public health departments in their community benefit activities (Carlton & Singh, 2018), a subset of hospitals partner with other community organizations, such as other health care providers, community nonprofits, and faith-based organizations (Cronin et al, 2021; Hearld & Karabukayeva, 2022; Park et al, 2020; Puro & Kelly, 2022). Hospital partnerships have the potential to improve communications across organizational sectors and break down silos among community stakeholders (Hilts et al, 2021). These partnerships also may support hospitals to address community health needs that fall outside of hospitals’ traditional expertise as acute medical care providers, such as behavioral health and social determinants of health (Gottlieb et al, 2019; Henize et al, 2015) (Gottlieb et al, 2019; Henize et al, 2015).…”

Characteristics of hospital and health system initiatives to address social determinants of health in the United States: a scoping review of the peer-reviewed literature

“…The remaining 378 articles were retrieved for full text review following which, 60 were excluded for not being an eligible article type, 20 for not being based in the US, and 221 for being outside the scope of the study. The remaining 77 articles were subjected to critical appraisal, following which 7 were excluded, leaving a total of 70 articles for final inclusion in the scoping review ( 23 , 24 , 27 , 34 , 43–108 ) The search results are summarized on the PRISMA chart in Figure 2 .…”

“…Despite growing attention to SDOH and the role of the healthcare sector in addressing them, there are no available scoping reviews of the peer-reviewed literature on hospital and health system-led initiatives to address SDOH. Existing reviews on the topic have focused on specific subtopics of SDOH (e.g., reviews of hospital partnerships to promote population health) ( 23 ), specific SDOH (e.g., health system efforts to address housing) ( 24 ), specific outcomes (e.g., impact of social support on hospital readmission rates) ( 25 ), specific diseases (e.g., impact of social determinants in spine surgery) ( 26 ), or specific populations (e.g., social risks among primary care patients) ( 27 ).…”

Longitudinal Trends in Insurer Participation in Multisector Population Health Activities

“…While several recent studies have focused on the evolving role of hospitals in population health initiatives, less is known about the role insurers play and how this has changed over time. 24 - 28 …”