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首页> 外文期刊>Frontiers in Public Health >Are Children's Hospitals Unique in the Community Benefits They Provide? Exploring Decisions to Prioritize Community Health Needs Among U.S. Children's and General Hospitals
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Are Children's Hospitals Unique in the Community Benefits They Provide? Exploring Decisions to Prioritize Community Health Needs Among U.S. Children's and General Hospitals

机译：儿童医院是否在他们提供的社区利益中是独一无二的？ 探索美国儿童和综合医院在优先考虑社区健康需求的决定

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The Affordable Care Act expanded community benefit requirements for nonprofit hospitals, which now must demonstrate that they take into account the needs of their surrounding community in deciding where to make community benefit investments. No study to date has assessed the Community Health Needs Assessments (CHNAs) of a large sample of nonprofit hospitals to understand how hospitals determine the priority health needs that they include for their community or how prioritized health needs differ between general and children's hospitals. We analyzed the CHNAs of a 20% random sample of general hospitals in the United States as well as all children's hospitals. After identifying the five most common needs across all hospitals—mental health, substance misuse, social needs, chronic illness, and access to care—we used descriptive statistics and multivariate logistic regression to determine which hospitals were most likely to prioritize each of these five needs in their CHNA and the organizational, county, and regional factors associated with prioritizing a need. We found that children's hospitals were more likely than general hospitals to prioritize each of these five needs in their CHNA and that related county-level health indicators were significantly associated with hospitals prioritizing social needs and substance misuse as top needs in their CHNAs. County-level demographic variation, such as the percentage of white residents, and regional location were significantly related to whether hospitals prioritized a need in their CHNA. Our results suggest that children's hospitals are more likely to include a similar list of health issues on their CHNAs and that factors beyond county-level health indicators (e.g., organizational mission, regional health indicators, etc.) are operative in hospital decisions to include needs on their CHNAs.
机译：经济实惠的护理法案扩大了非营利性医院的社区福利要求，现在必须证明他们考虑到他们周围社区的需求决定使社区受益投资的何处。迄今为止，迄今为止没有评估社区健康需求评估（CHNA）的大型非营利保健医院，以了解医院如何确定其为其社区提供的优先卫生需求，或者如何为一般和儿童医院之间的卫生需求有何不同。我们分析了美国在美国的20％综合医院随机样本以及所有儿童医院的CHNA。在确定所有医院的五个最常见的需求之后，药物滥用，物质滥用，社会需求，慢性疾病和护理，我们使用了描述性统计和多元逻辑回归，以确定哪些医院最有可能优先考虑这五种需求中的每一个优先考虑在他们的chna和组织，县和与优先事项相关的区域因素。我们发现，儿童的医院比综合医院更有可能优先考虑这五个需要在他们的CHNA中，并且相关的县级健康指标与优先考虑社会需求的医院有关，并将物质滥用作为其CHNA的最高需求。县级人口变异，如白人居民的百分比和区域地点与医院是否优先考虑在他们的chna中有关。我们的研究结果表明，儿童医院更有可能包括与他们的CHNA上类似的健康问题清单，并且超越县级健康指标（例如组织使命，区域卫生指标等）的因素在医院决定中均可包括所需的需求在他们的chnas上。

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