The influence of Federal Regulations and community health indicators on community benefit spending by private nonprofit hospital in some States of the US: A retrospective longitudinal correlational study
Introduction: In the United States, private nonprofit hospitals are exempt from federal, state, and local taxes in exchange for providing community benefits. Federal legislation in 2007 and 2010 established a standard re- porting format that allowed researchers to examine community benefit spending...
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Edizioni FS
2020-09-01
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| Series: | Journal of Health and Social Sciences |
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| Online Access: | https://journalhss.com/wp-content/uploads/jhss_53_331-342.pdf |
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| author | Wael ELRAYES David PALM Fernando WILSON Hongmei WANG Jane MEZA Robin HIGH Valerie PACINO |
| author_facet | Wael ELRAYES David PALM Fernando WILSON Hongmei WANG Jane MEZA Robin HIGH Valerie PACINO |
| author_sort | Wael ELRAYES |
| collection | DOAJ |
| description | Introduction: In the United States, private nonprofit hospitals are exempt from federal, state, and local taxes in exchange for providing community benefits. Federal legislation in 2007 and 2010 established a standard re- porting format that allowed researchers to examine community benefit spending patterns by private nonprofit hospitals, though this continues to be an understudied subject. The aim of this study was to assess whether the recent federal regulations and community health indicators influenced community benefit spending by private nonprofit hospitals in seven US states.
Methods: A retrospective longitudinal study was used to estimate the relationship between county-level com- munity health indicators in one year and levels of spending on community health improvement initiatives in the consecutive year for 223 urban and rural counties in seven US states. A generalized linear mixed model with lagged community health indicators and included multiple covariates was used.
Results: Only two of the fourteen community health indicators included in the analytical model were signifi- cantly associated with spending on community health improvement initiatives. The ratio of population to pri- mary care physicians was positively associated with spending (P < 0.0001), while adult smoking was negatively associated with spending on these activities (P = 0.003).
Discussion: Major variations exist in spending on community health improvement initiatives between counties in the same state and across different states. States with the highest health needs spent the least, while those with lowest health needs spent the most. The remarkable fluctuation in spending over the three years of the study could not be explained by a matching variability in the community health needs. Additional research should examine what factors influence the spending decisions by private nonprofit hospitals on community health improvement activities. |
| format | Article |
| id | doaj-art-66f6a0ce20fc48479b67740409950c26 |
| institution | Kabale University |
| issn | 2499-5886 2499-2240 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | Edizioni FS |
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| series | Journal of Health and Social Sciences |
| spelling | doaj-art-66f6a0ce20fc48479b67740409950c262025-01-18T18:20:30ZengEdizioni FSJournal of Health and Social Sciences2499-58862499-22402020-09-015333134210.19204/2020/thnf4The influence of Federal Regulations and community health indicators on community benefit spending by private nonprofit hospital in some States of the US: A retrospective longitudinal correlational studyWael ELRAYES0David PALM1Fernando WILSON2Hongmei WANG3Jane MEZA4Robin HIGH5Valerie PACINO6MBBCh, PhD, MS, FACHE, Assistant Professor, Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Nebraska, USA.PhD, Associate Professor, Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Nebraska, USA.PhD, Associate Professor, Matheson Center for Health Care Studies, University of Utah, 295 Chipeta Way, Salt Lake City, USAPhD, Associate Professor, Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Nebraska, USAPhD, Professor, Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Nebraska, USAMBA, MA, Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Nebraska, USAMPH, Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Nebraska, USAIntroduction: In the United States, private nonprofit hospitals are exempt from federal, state, and local taxes in exchange for providing community benefits. Federal legislation in 2007 and 2010 established a standard re- porting format that allowed researchers to examine community benefit spending patterns by private nonprofit hospitals, though this continues to be an understudied subject. The aim of this study was to assess whether the recent federal regulations and community health indicators influenced community benefit spending by private nonprofit hospitals in seven US states. Methods: A retrospective longitudinal study was used to estimate the relationship between county-level com- munity health indicators in one year and levels of spending on community health improvement initiatives in the consecutive year for 223 urban and rural counties in seven US states. A generalized linear mixed model with lagged community health indicators and included multiple covariates was used. Results: Only two of the fourteen community health indicators included in the analytical model were signifi- cantly associated with spending on community health improvement initiatives. The ratio of population to pri- mary care physicians was positively associated with spending (P < 0.0001), while adult smoking was negatively associated with spending on these activities (P = 0.003). Discussion: Major variations exist in spending on community health improvement initiatives between counties in the same state and across different states. States with the highest health needs spent the least, while those with lowest health needs spent the most. The remarkable fluctuation in spending over the three years of the study could not be explained by a matching variability in the community health needs. Additional research should examine what factors influence the spending decisions by private nonprofit hospitals on community health improvement activities.https://journalhss.com/wp-content/uploads/jhss_53_331-342.pdfaffordable care act; health expenditures; healthcare policy; patient protection; public health; usa |
| spellingShingle | Wael ELRAYES David PALM Fernando WILSON Hongmei WANG Jane MEZA Robin HIGH Valerie PACINO The influence of Federal Regulations and community health indicators on community benefit spending by private nonprofit hospital in some States of the US: A retrospective longitudinal correlational study Journal of Health and Social Sciences affordable care act; health expenditures; healthcare policy; patient protection; public health; usa |
| title | The influence of Federal Regulations and community health indicators on community benefit spending by private nonprofit hospital in some States of the US: A retrospective longitudinal correlational study |
| title_full | The influence of Federal Regulations and community health indicators on community benefit spending by private nonprofit hospital in some States of the US: A retrospective longitudinal correlational study |
| title_fullStr | The influence of Federal Regulations and community health indicators on community benefit spending by private nonprofit hospital in some States of the US: A retrospective longitudinal correlational study |
| title_full_unstemmed | The influence of Federal Regulations and community health indicators on community benefit spending by private nonprofit hospital in some States of the US: A retrospective longitudinal correlational study |
| title_short | The influence of Federal Regulations and community health indicators on community benefit spending by private nonprofit hospital in some States of the US: A retrospective longitudinal correlational study |
| title_sort | influence of federal regulations and community health indicators on community benefit spending by private nonprofit hospital in some states of the us a retrospective longitudinal correlational study |
| topic | affordable care act; health expenditures; healthcare policy; patient protection; public health; usa |
| url | https://journalhss.com/wp-content/uploads/jhss_53_331-342.pdf |
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