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Objective: The aim was to identify hospital and county characteristics associated with variation in breadth and depth of hospital partnerships with a broad range of organizations to improve population health. Data Sources: The American Hospital Association Annual Survey provided data on hospital partnerships to improve population health for the years 2017-2019. Design: The study adopts the dimensional publicness theory and social capital framework to examine hospital and county characteristics that facilitate hospital population health partnerships. The two dependent variables were number of local community organizations that hospitals partner with (breadth) and level of engagement with the partners (depth) to improve population health. The independent variables include three dimensions of publicness: Regulative, Normative and Cultural-cognitive measured by various hospital factors and presence of social capital present at county level. Covariates in the multivariate analysis included hospital factors such as bed-size and system membership. Methods: We used hierarchical linear regression models to assess various hospital and county factors associated with breadth and depth of hospital-community partnerships, adjusting for covariates. Principal Findings: Nonprofit and public hospitals provided a greater breadth (coefficient, 1.61; SE, 0.11; p < 0.001 and coefficient, 0.95; SE, 0.14; p < 0.001) and depth (coefficient, 0.26, SE, 0.04; p < 0.001 & coefficient, 0.13; SE, 0.05; p < 0.05) of partnerships than their for-profit counterparts, partially supporting regulative dimension of publicness. At a county level, we found community social capital positively associated with breadth of partnerships (coefficient, 0.13; SE, 0.08; p < 0.001). Conclusions: An environment that promotes collaboration between hospitals and organizations to improve population health may impact the health of the community by identifying health needs of the community, targeting social determinants of health, or by addressing patient social needs. However, findings suggest that publicness dimensions at an organizational level, which involves a culture of public value, maybe more important than county factors to achieve community building through partnerships. KEYWORDS hospital-community partnerships, population health, public value outcomes, publicness theory, social capital What is known on this topic * Prior work on hospital population health partnerships has focused on the individual partnerships of hospitals, rather than the breadth and engagement (depth) of those partnerships. * Hospital partnerships with higher level of engagement have the potential to improve population health by addressing social determinants of health at the community level or social needs at an individual level. What this study adds * This study explores various organizational and county level factors associated with variation in breadth and engagement of hospital population health partnerships. * This is one of the first studies to add a measure of engagement in hospital partnerships with community organizations in health-care literature. * This study advances publicness theory and highlight the role of organizational factors rather than county factors to explain variation in breadth and depth of hospital partnerships., 1 | INTRODUCTION The idea of population health management has gained traction among policymakers and health-care leaders in recent decades and was strengthened with the implementation of the Affordable Care [...]

Objective: To test whether the opioid epidemic increased hospitals' offerings of substance use services. Data Sources/Study Setting: This study employs data from the 2010 and 2015 American Hospital Association Annual Survey. Study Design: A multilevel, cross-sectional design was utilized to examine associations between county-level overdose rates and hospital substance use services. Data Collection/Extraction Methods: The analytic sample consisted of 3365 acute care hospitals that answered pertinent survey questions. Principal Findings: In 2010, 334 hospitals offered inpatient opioid services and 588 hospitals offered outpatient services, compared to 327 and 577, respectively, in 2015, indicating that more hospitals dropped services than added them as overdose rates increased. Factors other than growing need weigh more heavily in hospitals' determination to offer substance use services, including resources, mission, and the presence of psychiatric facilities within their communities. Importantly, hospitals that employ medical home models had greater odds of offering outpatient substance abuse services in 2015 OR, 95 percent CI (1.54; 1.23-1.93; P < 0.0001). Conclusions: Hospitals are either not willing or equipped to increase substance use services in response to growing need. KEYWORDS hospitals, inpatient care, outpatient care, substance use disorder, 1 | INTRODUCTION An epidemic of opioid misuse and corresponding overdose deaths has confronted the United States in the last decade. Although this impact has been national in scope, some [...]