Trends in the Provision of Community-Building Activities by Nonprofit Hospitals, 2010-2019

Singh, Samunder; Cronin, Cory E.; Puro, Neeraj; Franz, Berkeley

doi:10.1097/phh.0000000000001697

Cited by 4 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The outcomes presented in our study are only representative of hospitals that reported evaluation measures in their CHNAs. Our previous research has found that hospitals reporting evaluation measures are more likely to be system members, more likely to have hired a consultant to conduct their CHNA, and less likely to be located in rural areas compared to hospitals that did not report evaluation outcomes (Yeager et al, 2023). It is important to note that in coding evaluation outcomes, we were limited to the information that hospitals include in their publicly available CHNAs/IPs.…”

Section: Discussionmentioning

confidence: 99%

“…See prior work for more information on the complete coding protocol development and process . The current study relies on variables that were added to the coding protocol to assess how often hospitals report evaluation outcomes in their CHNAs (Yeager et al, 2023). More specifically, the primary variable capturing evaluation data was…”

Section: Initial Data Extractionmentioning

confidence: 99%

“…Evaluation of strategies is a crucial step to ensure that the impact being made on the community is commensurate with the expected benefit of forgone taxes (Rubin et al, 2013). However, guidelines on what constitutes "evaluation" are vague, contributing to wide variation in the information reported in the evaluation section of CHNAs (Yeager et al, 2023). Given that there are approximately 3,000 nonprofit hospitals in the United States, conducting meaningful evaluation of strategies and using this information to inform decision-making in future CHNAs/IPs offers an opportunity to reduce disparities and improve community health.…”

mentioning

confidence: 99%

“…Existing studies have focused on interventions related to childhood obesity (Eneli et al, 2018;Hoke et al, 2015), hospital emergency department utilization (Botieri et al, 2016;Larson, 2016), preventive screenings (e.g., cardiac risk factors; Cheong & Butao, 2018), health education (Raber et al, 2018), community programming (Cheadle et al, 2018), community garden access (George et al, 2017), neighborhood development (Franz et al, 2018;Kelleher et al, 2018), diabetes self-management programs (Freeman et al, 2018), and fitness center access (Yang et al, 2015). In a more recent analysis of a nationally representative sample of CHNAs, fewer than 20% of hospitals reported a social or health outcome when evaluating their community benefit strategies (Yeager et al, 2023). Decades of research have described the importance of social determinants of health in shaping health outcomes (Kaiser Family Foundation, 2023;World Health Organization, 2023), yet few studies have examined how community benefit strategies addressing social determinants ultimately influence health outcomes .…”

mentioning

confidence: 99%

See 3 more Smart Citations

New insights about community benefit evaluation

Burns,

Yeager,

Vest

et al. 2024

Health Care Manage Rev

Self Cite

View full text Add to dashboard Cite

Background Nonprofit hospitals are required to conduct community health needs assessments (CHNA) every 3 years and develop corresponding implementation plans. Implemented strategies must address the identified community needs and be evaluated for impact. Purpose Using the Community Health Implementation Evaluation Framework (CHIEF), we assessed whether and how nonprofit hospitals are evaluating the impact of their CHNA-informed community benefit initiatives. Methodology We conducted a content analysis of 83 hospital CHNAs that reported evaluation outcomes drawn from a previously identified 20% random sample (n = 613) of nonprofit hospitals in the United States. Through qualitative review guided by the CHIEF, we identified and categorized the most common evaluation outcomes reported. Results A total of 485 strategies were identified from the 83 hospitals’ CHNAs. Evaluated strategies most frequently targeted behavioral health (n = 124, 26%), access (n = 83, 17%), and obesity/nutrition/inactivity (n = 68, 14%). The most common type of evaluation outcomes reported by CHIEF category included system utilization (n = 342, 71%), system implementation (n = 170, 35%), project management (n = 164, 34%), and social outcomes (n = 163, 34%). Practice Implications CHNA evaluation strategies focus on utilization (the number of individuals served), with few focusing on social or health outcomes. This represents a missed opportunity to (a) assess the social and health impacts across individual strategies and (b) provide insight that can be used to inform the allocation of limited resources to maximize the impact of community benefit strategies.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Initial Data Extractionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

New insights about community benefit evaluation

Burns,

Yeager,

Vest

et al. 2024

Health Care Manage Rev

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our coding strategy was developed using a previous round of community benefit documents and is reported elsewhere. 20 We coded CHNAs for the top 5 health needs identified, and then coded the top 5 health needs addressed in the corresponding IS. The coding team underwent structured training on the coding strategy, and we tested for interrater reliability with a set of 15 test documents.…”

Section: Methodsmentioning

confidence: 99%

A national overview of nonprofit hospital community benefit programs to address the social determinants of health

Franz,

Burns,

Kueffner

et al. 2023

Health Affairs Scholar

Self Cite

View full text Add to dashboard Cite

Decades of research have solidified the crucial role that social determinants of health (SDOH) play in shaping health outcomes, yet strategies to address these upstream factors remain elusive. The aim of this study was to understand the extent to which US nonprofit hospitals invest in SDOH at either the community or individual patient level and to provide examples of programs in each area. We analyzed data from a national dataset of 613 hospital community health needs assessments and corresponding implementation strategies. Among sample hospitals, 69.3% (n = 373) identified SDOH as a top-5 health need in their community and 60.6% (n = 326) reported investments in SDOH. Of hospitals with investments in SDOH, 44% of programs addressed health-related social needs of individual patients, while the remaining 56% of programs addressed SDOH at the community level. Hospitals that were major teaching organizations, those in the Western region of the United States, and hospitals in counties with more severe housing problems had greater odds of investing in SDOH at the community level. Although many nonprofit hospitals have integrated SDOH-related activities into their community benefit work, stronger policies are necessary to encourage greater investments at the community-level that move beyond the needs of individual patients.

show abstract

Mixed-Methods Analysis of Community-Building Activities in Minnesota Hospitals

MacDougall,

Libal,

Loomer

2024

Health &Amp; Social Work

View full text Add to dashboard Cite

Nonprofit hospitals are required to annually report spending on community-building activities (CBAs) to the Internal Revenue Service. CBAs are actions that address root causes of community health problems such as housing and food insecurity. While addressing these issues is important regardless of location, CBA spending could particularly benefit rural residents who, on average, experience worse health outcomes. However, national CBA spending has historically been extremely low, potentially due to confusion surrounding reporting. This explanatory mixed-methods study sought to illuminate nonprofit hospital spending patterns on CBAs in one state, Minnesota, to understand why spending in this important category is so low. Authors first conducted quantitative analyses of publicly available tax return data for the year 2019’ which revealed no statistically significant differences in CBA spending by rural location or hospital system affiliation. Authors then performed a case study of the top spending hospitals’ narrative statements provided in nonprofit hospital tax return documents and found significant variation in what is reported as a CBA. We suggest CBA spending be reported differently to reduce confusion and render tax documents more accurate portrayals of nonprofit hospital spending, thereby providing policymakers with needed information to ensure nonprofit hospitals are financially supporting community health.

show abstract

Trends in the Provision of Community-Building Activities by Nonprofit Hospitals, 2010-2019

Cited by 4 publications

References 12 publications

New insights about community benefit evaluation

New insights about community benefit evaluation

A national overview of nonprofit hospital community benefit programs to address the social determinants of health

Mixed-Methods Analysis of Community-Building Activities in Minnesota Hospitals

Contact Info

Product

Resources

About