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Not-for-profit hospitals (NFPs) frequently partner with community organizations to conduct internal revenue service-mandated community health needs assessment (CHNA), yet little is known about the number of partnerships that hospitals enter into for this purpose. This article uses "American Hospital Associations' 2020 Annual Survey" data to examine hospital-community partnerships around the CHNA and the role that community social capital defined as, "the networks that cross various professional, political and social boundaries to reflect community level trust needed to pursue shared objectives" plays in hospitals' choices to partner with community organizations for the CHNA. After controlling for a set of hospital, community, and state characteristics, we found that hospitals present in communities with higher social capital were likely to partner with more community organizations to conduct CHNA. Greater social capital may thus promote community health by facilitating the partnerships NFPs develop with community organizations to conduct the CHNA. [ABSTRACT FROM AUTHOR]

Hospitals have the ability to serve as anchor institutions that not only provide clinical care but make important community investments through employment, and outreach, and engagement efforts that address the social determinants of health. In doing so, hospitals may partner with community members and community-based organizations, but the extent to which local residents participate in directing local investments varies across organizations. This study looks at the role of hospitals as anchor institutions and the best practices for leveraging community participation in planning investments to improve social and economic health in communities. We used an inductive, qualitative approach to understand the incentives hospitals have to anchor themselves within their communities and how best practices can be leveraged. We conducted 28 in-depth interviews with 27 hospital leaders and personnel, and one interview with a member of a for-profit hospital advocacy organization. Drawing on thematic analysis, three primary themes were identified as critical to leveraging community-driven anchor activities: strong and intentional community-oriented leadership; direct community involvement; and non-regulatory incentives, including incentive programs. The more institutions, organizations, communities, and individuals expect community-oriented anchor activities from hospitals, the more likely they are to engage in such activities. Critical to this work is ensuring that community members themselves are able to help direct the investments of hospitals in alignment with community health needs. Community stakeholders, including elected officials, public health offices, and policymakers, have important leverage in creating expectations for hospitals to engage in anchor activities and facilitate community-based partnerships as a part of this process. [ABSTRACT FROM AUTHOR]

Rationale: Hospitals have a longstanding presence in United States communities and contribute to economic development and community well‐being through widespread employment, purchasing and direct community engagement. Most of the data on anchor institutions to date, however, has focused on nonprofit organisations, especially nonprofit hospitals, colleges and universities. The aim of this study is to better understand if for‐profit hospitals engage in explicit anchor activities, and whether these organisations adopt unique strategies in carrying out this study. Methods: We used an inductive, qualitative approach to understand how for‐profit hospitals perceive their anchoring efforts as distinct as compared to nonprofits. We conducted in‐depth interviews with 23 hospital leaders, researchers and members of advocacy organisations, representing 11 different hospital organisations and 10 communities; and used thematic analysis to generate study findings. Results: For‐profit hospitals do see at least three primary differences that render them distinctive in their efforts to anchor themselves within their communities—namely, barriers that for‐profits encounter that nonprofits may not; their emphasis on strategic and synergistic practices; and their status as hospitals that also support their communities economically as tax‐paying entities. Conclusion: With a better understanding of their unique contributions as for‐profit organisations, policymakers can identify ways to leverage these hospitals to support their communities through outreach and engagement. [ABSTRACT FROM AUTHOR]

Cross-sector collaboration is critical to improving population health, but data on partnership activities by children's hospitals are limited, and there is a need to identify service delivery gaps for families. The aim of this study is to use public community benefit reports for all children's hospitals in the United States to assess the extent to which children's hospitals partner with external organizations to address five key health needs: health care access, chronic disease, social needs, mental health, and substance abuse. Strategies that involved partnering with community organizations were most common in addressing social needs and substance abuse. When adjusted for institutional and community characteristics hospitals in a multilevel regression model, hospitals had higher odds of partnering to address chronic illness and social needs. To encourage hospital engagement with complex social and behavioral health needs and promote health equity, support should be provided to help hospitals establish local population health networks. [ABSTRACT FROM AUTHOR]

The U.S. epidemic of opioid abuse calls for broad collaboration between a wide range of health care institutions and the various levels of government. Through the community benefit programs they provide, nonprofit hospitals are well positioned to be key partners in local efforts. Although substance abuse appears on approximately 90% of the most recent community health needs assessments completed by hospitals, many hospitals are not addressing substance abuse in their programmatic efforts. Given wide state variation in policies to combat opioid abuse, we assess whether state leadership to address the opioid crisis influences hospital decisions to invest in substance abuse programs. Our findings suggest that several key state policies are related to hospital investments in substance abuse initiatives. To capitalize on the community benefit responsibilities of local hospitals, policies that provide specific direction for and engagement with local hospitals may increase cooperation and investments to address substance abuse. [ABSTRACT FROM AUTHOR]

Hospitals are an ideal setting to stage opioid-related interventions with patients who are hospitalized due to overdose or other substance use–related complications. Transitional opioid programs—which initiate care and provide linkages upon discharge, such as screening, initiation of medications for opioid use disorder, and addiction consult services—have become the gold standard, but implementation has been uneven. The purpose of this study was to assess disparities in the availability of hospital-based transitional opioid programs, across rural and urban hospital settings in the United States. Using hospital administrative data paired with county-level demographic data, we conducted bivariate and regression analyses to assess rural-urban differences in the availability of transitional opioid services including screening, addiction consult services, and MOUD in U.S general medical centers, controlling for hospital- and community-level factors. Our sample included 2846 general medical hospitals that completed the 2021 American Hospital Association (AHA) Annual Survey of Hospitals. Our primary outcomes were five self-reported measures: whether the hospital provided screening in the ED; provided screening in the inpatient setting; whether the hospital provided addiction consult services in the ED; provided addiction consult services in the inpatient setting; and whether the hospital provided medications for opioid use disorder. Rural hospitals did not have lower odds of screening for OUD or other SUDs than urban hospitals, but both micropolitan rural counties and noncore rural counties had significantly lower odds of having addiction consult services in either the ED (OR: 0.74, 95 % CI: 0.58, 0.95; OR: 0.68, 95 % CI: 0.50, 0.91) or inpatient setting (OR: 0.76, 95 % CI: 0.59, 0.97; OR: 0.68, 95 % CI: 0.50, 0.93), respectively, or of offering MOUD (OR: 0.69, 95 % CI: 0.52, 0.90; OR: 0.52, 95 % CI: 0.37, 0.74). Our study suggests that evidence-based interventions, such as medications for opioid use disorder and addiction consult services, are less often available in rural hospitals, which may contribute to rural-urban disparities in health outcomes secondary to OUD. A priority for population health improvement should be developing implementation strategies to support rural hospital adoption of transitional opioid programs. • Rural and urban hospitals have similar screening rates for opioid use disorder. • Rural hospitals have lower odds of offering addiction consult services and MOUD. • Rural hospitals may need implementation support to offer transitional opioid programs. [ABSTRACT FROM AUTHOR]

Objectives: Hospitals are on the front lines of the opioid epidemic, seeing patients who overdose or have complicated infections, but the extent of services offered or whether services are evidence-based is not known. The objective of our study was to assess the extent to which nonprofit hospitals are addressing opioid abuse, a critical public health issue, through their community benefit work and to identify which evidence-based strategies they adopt. Methods: We reviewed community benefit documents from January 1, 2015, through December 31, 2018, for a sample (N = 446) of all nonprofit hospitals in the United States. We classified hospital opioid-related strategies into 9 categories. Using logistic regression, we predicted the likelihood of hospitals adopting various strategies to address opioid abuse. Results: Of the 446 nonprofit hospitals in our sample, 49.1% (n = 219) adopted ≥1 clinical strategy to address opioid use disorder in their community. Approximately one-quarter (26.5%; n = 118) of hospitals adopted a strategy related to treatment services for substance use disorder; 28.2% (n = 126) had ≥1 program focused on connecting patients to a primary care medical home, and 14.6% (n = 65) focused on caring for patients with opioid-related overdoses in the emergency department. We also identified factors that predicted involvement in programs that were less common than clinical strategies, but potentially effective, such as harm reduction and prescriber initiatives (both 6.3% of hospitals). Conclusions: Evidence-based prevention and treatment require strong collaboration between health care and community institutions at all levels. Effective policy interventions may exist to encourage various types and sizes of nonprofit hospitals to adopt evidence-based interventions to address opioid abuse in their communities. [ABSTRACT FROM AUTHOR]