Local Health Department and Hospital Collaboration Around Community Health Needs Assessment to Improve Health Outcomes

Isehunwa, Oluwaseyi O.; Dobalian, Aram; Ahn, SangNam; Relyea, George; Carlton, Erik L.

doi:10.1097/fch.0000000000000280

Cited by 6 publications

(20 citation statements)

References 30 publications

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“…This review was limited to sources from high-income countries with developed economies: 56 from the United States, 41 , 43 – 46 , 52 , 54 , 56 , 59 , 64 – 68 , 71 , 73 , 74 , 78 , 80 , 83 , 84 , 89 , 92 , 95 – 97 , 99 – 101 , 103 , 105 – 107 , 115 , 119 – 121 , 124 , 125 , 128 , 134 – 139 , 142 – 147 , 149 – 151 , 153 20 from Canada, 35 , 37 , 39 , 40 , 42 , 48 – 50 , 63 , 86 , 88 , 90 , 91 , 98 , 104 , 108 , 113 , 141 , 152 , 155 16 from the United Kingdom, 38 , 53 , 55 , 61 , 62 , 69 , 70 , 81 , 85 , 87 , 112 , ...…”

Section: Resultsmentioning

confidence: 99%

“…Figure 2 includes the context or setting for the included sources. Primary health care (n=58) was the setting for almost half of the included sources, 21 , 37 , 39 – 42 , 44 , 45 , 47 – 51 , 54 , 56 , 57 , 62 , 63 , 65 , 67 , 72 , 73 , 75 , 77 , 79 , 81 – 84 , 87 , 88 , 91 , 94 – 96 , 98 – 100 , 104 , 106 , 108 – 110 , 112 , 114 – 116 , 122 , 123 , 125 , 128 , 129 , 140 , 142 , 143 , 146 , 152 , 153 followed by health service/delivery system (n=31), 35 , 36 , 38 , 43 , 71 , 92 , 93 , 97 , 102 , 103 , 105 , 107 , 111 , 117 – 121 , 124 , 126 , 130 , 132 ,…”

Section: Resultsmentioning

confidence: 99%

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Strategies and indicators to integrate health equity in health service and delivery systems in high-income countries: a scoping review

Caldwell,

Yusuf,

Carrea

et al. 2024

JBI Evidence Synthesis

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Objective: The objective of this review was to describe how health service and delivery systems in high-income countries define and operationalize health equity. A secondary objective is to identify implementation strategies and indicators being used to integrate and measure health equity. Introduction: To improve the health of populations, a population health and health equity approach is needed. To date, most work on health equity integration has focused on reducing health inequities within public health, health care delivery, or providers within a health system, but less is known about integration across the health service and delivery system. Inclusion criteria: This review included academic and gray literature sources that described the definitions, frameworks, level of integration, strategies, and indicators that health service and delivery systems in high-income countries have used to describe, integrate, and/or measure health equity. Sources were excluded if they were not available in English (or a translation was not available), were published before 1986, focused on strategies that were not implemented, did not provide health equity indicators, or featured strategies that were implemented outside the health service or delivery systems (eg, community-based strategies). Methods: This review was conducted in accordance with the JBI methodology for scoping reviews. Titles and abstracts were assessed followed by a full-text review. The information extracted consisted of study design and key findings, such as health equity definitions, strategies, frameworks, level of integration, and indicators. Most data have been quantitatively tabulated and presented according to 5 review questions. Some findings (eg, definitions and indicators) were summarized using qualitative methods. Most findings are visually presented in charts and diagrams or presented in tabular format. Results: Following review of 16,297 titles and abstracts and 824 full-text sources, we included 122 sources (113 peer-reviewed, 9 gray literature) in this scoping review. We found that health equity was inconsistently defined and operationalized. Only 17 sources included definitions of health equity and we found that both indicators and strategies were lacking adequate descriptions. The use of health equity frameworks was limited and, where present, there was little consistency or agreement in their use. We found that strategies were often specific to programs, services, or clinics, rather than broadly applied across health service and delivery systems. Conclusions: Our findings suggest that strategies to advance health equity work are siloed within health service and delivery systems and are not currently being implemented system-wide (ie, across all health settings). Healthy equity definitions and frameworks are varied in the included sources, and indicators for health equity are variable and inconsistently measured. Health equity integration needs to be prioritized within and across health service and delivery systems. There is also a need for system-wide strategies to promote health equity, alongside robust accountability mechanisms for measuring health equity. This is necessary to ensure that an integrated, whole-system approach can be consistently applied in health service and delivery systems internationally. Review registration: Dal Space dalspace.library.dal.ca/handle/10222/80835 Supplemental digital content is available for this review: http://links.lww.com/SRX/A45

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Strategies and indicators to integrate health equity in health service and delivery systems in high-income countries: a scoping review

Caldwell,

Yusuf,

Carrea

et al. 2024

JBI Evidence Synthesis

View full text Add to dashboard Cite

show abstract

“…At the same time, hospital leaders had limited experience with community health assessments prior to the ACA ( 10 ), and some report up to tens of thousands of hours of personnel time to comply with existing guidelines ( 11 ). Greater collaboration can promote greater efficiencies ( 12 ), increase hospital spending on community benefit activities ( 13 ), encourage evidence-based decision-making to address community health outcomes ( 14 ), and promote a shared understanding of community health ( 15 ). However, content analyses of CHNA and implementation plan reports reveal limited collaboration with other hospitals or public health agencies ( 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

An action research partnership in an urban Texas county to explore barriers and opportunities for collaborative community health needs assessments

Nava,

English,

Fulmer

et al. 2023

Front. Public Health

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BackgroundThe Affordable Care Act mandated triennial community health needs assessments (CHNAs) for greater nonprofit hospital accountability in responding to community health needs. Over 10 years later, hospital spending on community benefits remains largely unchanged. While greater collaboration in CHNA implementation can increase hospital investment in community-based initiatives, nonprofit hospitals in conservative states are subject to policy, political, and economic factors that inhibit public health partnerships and magnify existing disparities in health care access. This participatory action research study explores the decision-making environment of collaborative CHNA implementation within a group of nonprofit hospitals in a north Texas urban county.MethodsIn 2017 faculty from an urban anchor institution initiated an academic-community partnership with a coalition of nonprofit hospitals, public health departments, and academic institutions. An interdisciplinary research team engaged in multi-method document review and qualitative data collection to describe historical barriers for local CHNA processes and develop practical strategies for joint CHNA initiatives. Local CHNA documents were first reviewed through team-based content analysis and results applied to develop a qualitative study protocol. Key informants were recruited from county-based nonprofit hospitals, community-based nonprofit organizations, and public health systems. Seventeen senior- and mid-level professionals participated in semi-structured research interviews to describe their perspectives relating to CHNA-related planning and implementation decisions. Through iterative data collection and analysis, the research team explored CHNA-related knowledge, experiences, and processes. A constructivist lens was subsequently applied to examine historical barriers and future opportunities for local collaboration.ResultsFindings reveal CHNA implementation is a multi-stage cyclical process in organizational environments with accountability to a wide range of public and private stakeholders. This promotes varied levels of inclusivity and conservatism in data collection and community benefit implementation. Decisions to collaborate are hindered by competing priorities, including compliance with existing guidelines, administrative simplicity, alignment with health care service delivery, and efficient resource use. Efforts to promote greater CHNA collaboration may be facilitated through intentional alignment with organizational priorities and clearly communicated benefits of participation for leaders in both public and private nonprofit health systems.DiscussionWe consider implications for policymakers and health systems in restrictive political environments and advance a conceptual framework for greater CHNA collaboration.

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“…A better understanding of the role that LHDs play in the development of nonprofit hospitals' CHNAs and implementation strategy has the potential to ensure that hospitals use their limited resources for community health improvement in the most effective and efficient ways. Moreover, a better understanding of LHDs' role in the CHNA process may shed light on the pathways through which hospital-LHD collaborations around the CHNA may improve individual health behaviors and community health outcomes 6,7…”

mentioning

confidence: 99%

“…Moreover, a better understanding of LHDs' role in the CHNA process may shed light on the pathways through which hospital-LHD collaborations around the CHNA may improve individual health behaviors and community health outcomes. 6,7…”

mentioning

confidence: 99%

The Role of Local Health Departments in Strengthening the Alignment Between Nonprofit Hospitals' Community Health Needs Assessments and Their Implementation Strategies

Singh

Cronin

Yeager

et al. 2022

Journal of Public Health Management and Practice

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Nonprofit hospitals frequently partner with their local health department on developing community health needs assessments (CHNAs); yet, little is known about the role that such partnerships play in strengthening the alignment between needs identified in hospitals' assessments and the strategies adopted by hospitals to address identified needs. Using data for 486 hospitals from the third round of CHNAs (spanning the years 2018-2021), this study showed strong alignment between the health needs identified in the CHNAs and those addressed in hospitals' implementation strategies, independent of collaboration with the local health department. One noteworthy exception to this finding was that hospital-public health collaboration remained important for improved alignment of needs related to substance use. Involvement of the local health department may strengthen hospitals' capacity to address needs outside their traditional areas of expertise, such as substance use. KEY WORDS: community health needs assessment, hospital-public health partnerships, nonprofit hospitalsN onprofit hospitals frequently partner with their local health department (LHD) in the development of their Internal Revenue Service (IRS)-mandated community health needs assessment (CHNA); yet, little is known about the role that such partnerships play in strengthening the alignment between the needs identified in hospitals' CHNAs and the strategies hospitals implement to address identified needs. Conceptually, CHNAs provide

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Local Health Department and Hospital Collaboration Around Community Health Needs Assessment to Improve Health Outcomes

Cited by 6 publications

References 30 publications

Strategies and indicators to integrate health equity in health service and delivery systems in high-income countries: a scoping review

Strategies and indicators to integrate health equity in health service and delivery systems in high-income countries: a scoping review

An action research partnership in an urban Texas county to explore barriers and opportunities for collaborative community health needs assessments

The Role of Local Health Departments in Strengthening the Alignment Between Nonprofit Hospitals' Community Health Needs Assessments and Their Implementation Strategies

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