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首页> 美国卫生研究院文献>Health Services Research >Hospital Collaboration with Local Health Departments on Community Health Improvement Activities: Is the Whole More Effective Than the Sum of Its Parts?
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Hospital Collaboration with Local Health Departments on Community Health Improvement Activities: Is the Whole More Effective Than the Sum of Its Parts?

机译：与当地卫生部门的医院合作社区健康改善活动：整体均比其零件的总和更有效吗？

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We examined the effect of nonprofit hospital (NFP) and local health department (LHD) collaboration in local health planning on drug‐induced mortality. NFPs must provide certain types of community benefit (CB) in order to keep their tax‐exempt status. The IRS reported that NFPs spent over $60 billion on CB activities in 2011. Despite the magnitude of spending, there is little evidence as to whether this spending leads to tangible improvements in population health. Traditionally, NFPs dedicated most of their CB dollars to charity care, health professions education, and research. While these areas of spending are beneficial to the community, they represent a partial fulfillment of the CB requirement per the IRS. NFPs are also expected to improve the overall health of the communities they serve by providing health care and prevention activities outside its four walls. Section 9007 of the PPACA, part of the IRS CB requirement, is a regulatory approach that steers NFPs toward providing community health activities that fall outside its acute care focus. It required NFPs to submit a triennial community health needs assessment (CHNA) and an implementation strategy. A few states have leveraged Section 9007 to encourage collaboration between NFPs and LHDs. New York (NY) is the only state that has required NFPs and LHD to collaborate on all three of the following key local health planning activities: CHNA, joint selection of health priorities, and joint implementation of initiatives to address health priorities.
机译：我们研究了非营利性医院（NFP）和地方卫生部（LHD）在局部健康规划中对药物诱导的死亡率的影响。 NFPS必须提供某些类型的社区福利（CB），以保持其税收豁免状态。美国国税局报告说，NFPS于2011年在CB活动中花了超过600亿美元。尽管支出的规模，但这几乎没有证据表明，这项支出是否导致人口健康的有形改善。传统上，NFPS专注于大多数CB美元到慈善护理，健康专业教育和研究。虽然这些支出领域有益于社区，但它们代表了每股美国国税局的CB要求的部分履行。还预计NFPS还将通过提供四墙外的保健和预防活动来改善他们服务的社区的整体健康。 PPACA第9007条，部分IRS CB要求，是一种监管方法，使NFPS提供落地的社区健康活动，这些活动落在其急性护理焦点之外。它需要NFPS提交三年期社区健康需求评估（CHNA）和实施策略。一些国家已杠杆第9007节，以鼓励NFP和LHD之间的合作。纽约（纽约州）是唯一需要NFPS和LHD在以下三项关键当地健康计划活动中合作的国家：CHNA，联合选择卫生优先事项，以及联合实施解决卫生优先事项的举措。

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