Indiana Nonprofit Hospitals’ Community Health Needs Assessments Objectives and Evaluation
Over half of the hospitals in the United States are not for profit and confer large tax advantages so long as they demonstrate community benefit. Since 2010 these hospitals have been required by law to conduct Community Health Needs Assessments (CHNAs) in order for community benefit to move from charity care to improved population health outcomes. For improved population health outcomes, we argue that effective community health programs must be put into place with high quality goals and evaluations to ensure effectiveness. We rated the objectives and evaluation plans of Indiana nonprofit hospitals’ CHNAs and then compared and correlated the quality of these plans with characteristics of the hospitals and health indicators of their community.
CHNAs and Implementation Plans were obtained for 95 nonprofit hospitals in Indiana. The assessments and plans were independently scored by 2 assessors based on specific criteria for quality using a Likert scale which ranged from 0 to 5. We averaged the scores and then correlated and compared them to characteristics of the hospital, its local partnerships, and the health statistics of the communities in which they reside.
The average score for the objectives was 3.43 and for the evaluation 2.47 with large variations in the criteria met by each hospitals CHNA. Significant differences were found between the scores of system-based and independent hospitals for both evaluation and objectives (p=0.01, p<0.001).
Conclusion and Potential Impact:
Our data shows that the quality of CHNAs’ objectives and evaluation is universally poor and vary greatly from hospital to hospital. However, consistency and to a lesser degree quality of scores can be affected by system wide models. If the goal of these assessments is to create better population health outcomes through nonprofit hospitals, then the government needs to provide a high-quality model for hospitals to follow.
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