Changes in hospital-supported substance use services across US nonprofit hospitals, 2015-2021.

Substance use remains a timely and important community need to understand and address. Nonprofit hospitals are in a unique position to identify needs and develop programs in response to substance use challenges in their communities. To better understand how nonprofit hospitals do this, we collected data from community health needs assessments and their corresponding implementation strategy (IS) to address these needs for a 20% random sample of hospitals in each state of the United States over 2 periods (2015-2018 and 2019-2021).

Barriers and Facilitators to Establishing Partnerships for Substance Use Disorder Care Transitions Between Safety-Net Hospitals and Community-Based Organizations.

Background: The effectiveness of hospital-based transitional opioid programs (TOPs), which aim to connect patients with substance use disorders (SUD) to ongoing treatment in the community following initiation of medication for opioid use disorder (MOUD) treatment in the hospital, hinges on successful patient transitions. These transitions are enabled by strong partnerships between hospitals and community-based organizations (CBOs). However, no prior study has specifically examined barriers and facilitators to establishing SUD care transition partnerships between hospitals and CBOs.

Ohio Presents Opportunities For Understanding Hospital Alignment With Public Health Agencies On Community Health Assessments.

Multisector collaboration is critical for improving population health. Improving alignment between nonprofit hospitals and local health departments is one promising approach to achieving health improvement, and a number of states are exploring policies to facilitate such collaboration. Using public documents, we evaluated the alignment between Ohio nonprofit hospitals and local health departments in the community health needs they identify and those they prioritize.

New insights about community benefit evaluation: Using the Community Health Implementation Evaluation Framework to assess what hospitals are measuring.

Background: Nonprofit hospitals are required to conduct community health needs assessments (CHNA) every 3 years and develop corresponding implementation plans. Implemented strategies must address the identified community needs and be evaluated for impact.

Purpose: Using the Community Health Implementation Evaluation Framework (CHIEF), we assessed whether and how nonprofit hospitals are evaluating the impact of their CHNA-informed community benefit initiatives.

A national overview of nonprofit hospital community benefit programs to address the social determinants of health.

Decades of research have solidified the crucial role that social determinants of health (SDOH) play in shaping health outcomes, yet strategies to address these upstream factors remain elusive. The aim of this study was to understand the extent to which US nonprofit hospitals invest in SDOH at either the community or individual patient level and to provide examples of programs in each area. We analyzed data from a national dataset of 613 hospital community health needs assessments and corresponding implementation strategies.

Public perceptions of US for-profit, nonprofit, and public hospitals.

Nonprofit hospitals have been criticized for behaving like for-profit hospitals. One prominent defense of nonprofit hospitals is contract failure theory, which suggests that nonprofits are important in markets defined by information asymmetries. Unlike for-profits, nonprofit hospitals' inability to distribute profits may provide patients with an important assurance that they will not be exploited in the course of receiving care.

National Overview of Nonprofit Hospitals' Community Benefit Programs to Address Housing.

Background: Housing is a critical social determinant of health that can be addressed through hospital-supported community benefit programming.

Objectives: To explore the prevalence of hospital-based programs that address housing-related needs, categorize the specific actions taken to address housing, and determine organizational and community-level factors associated with investing in housing.

Research Design: This retrospective, cross-sectional study examined a nationally representative dataset of administrative documents from nonprofit hospitals that addressed social determinants of health in their federally mandated community benefit implementation plans.

Alignment of substance use community benefit prioritization and service lines in US hospitals: a cross-sectional study.

Background: Non-profit hospitals in the U.S. are required by the 2010 Patient Protection and Affordable Care Act (ACA) to conduct a community health needs assessment (CHNA) every three years and to formulate an implementation strategy in response to those needs.

Rural-urban disparities in the availability of hospital-based screening, medications for opioid use disorder, and addiction consult services.

Introduction: 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.

Differential impact of hospital and community factors on breadth and depth of hospital population health partnerships.

Objective: The aim was to identify hospital and county characteristics associated with variation in breadth and depth of hospital partnerships with a broad range of organizations to improve population health.

Data Sources: The American Hospital Association Annual Survey provided data on hospital partnerships to improve population health for the years 2017-2019.

Design: The study adopts the dimensional publicness theory and social capital framework to examine hospital and county characteristics that facilitate hospital population health partnerships.

Alzheimer's Centers in US Hospitals: Enough to Adequately Address Dementia Care Nationwide?

To investigate the availability of Alzheimer's Centers (ACs) in US hospitals. Utilizing the American Hospital Association Annual Survey, Area Health Resource File, and US Census ( = 3251), we employed multivariable logistic regression to examine hospital, county, and regional predictors of AC availability. Large hospitals (>399 beds) had approximately 14 times higher odds of having an AC than small hospitals (<50 beds; OR = 14.

Substance Use Disorder Program Availability in Safety-Net and Non-Safety-Net Hospitals in the US.

Importance: Safety-net hospitals (SNHs) are ideal sites to deliver addiction treatment to patients with substance use disorders (SUDs), but the availability of these services within SNHs nationwide remains unknown.

Objective: To examine differences in the delivery of different SUD programs in SNHs vs non-SNHs across the US and to determine whether these differences are increased in certain types of SNHs depending on ownership.

Design, Setting, And Participants: This cross-sectional analysis used data from the 2021 American Hospital Association Annual Survey of Hospitals to examine the associations of safety-net status and ownership with the availability of SUD services at acute care hospitals in the US.

Trends in the Prioritization and Implementation of Substance Use Programs by Nonprofit Hospitals: 2015-2021.

Objectives: Hospitalizations are an important opportunity to address substance use through inpatient services, outpatient care, and community partnerships, yet the extent to which nonprofit hospitals prioritize such services across time remains unknown. The objective of this study is to examine trends in nonprofit hospitals' prioritization and implementation of substance use disorder (SUD) programs.

Methods: We assessed trends in hospital prioritization of substance use as a top five community need and hospital implementation of SUD programing at nonprofit hospitals between 2015 and 2021 using two waves (wave 1: 2015-2018; wave 2: 2019-2021) by examining hospital community benefit reports.

From microbe to metaphor: virus-like problems in organizations.

Despite the important role of problem-solving in organizations, our understanding of the fundamental nature of problems is limited. To generate insights and discussion on this topic, we introduce the metaphor of a "virus-like" problem, which is a special kind of problem that often escapes the awareness of organizational leaders. Virus-like problems differ from other problems in organizations because, just like actual viruses, they are hidden, their source is difficult to identify, and they can quickly spread to others.

Evaluation of Community Benefit Activities Among Nonprofit Hospitals, 2018-2021.

Objective: This study examined approaches that nonprofit hospitals use to evaluate community benefit activities in the Community Health Needs Assessment/Implementation Plan (CHNA/IP) process.

Design: Content analysis of CHNAs/IPs completed between 2018 and 2021 from a 20% stratified random sample (n = 503) of US nonprofit hospitals.

Main Outcome Measures: A coding sheet was used to record details about the evaluation content reported by hospitals in their CHNAs/IPs.

The public availability of hospital CHNA reports: limitations and potential to study hospital investments in the next phase of public health.

Nonprofit hospitals have been required to complete and make publicly available their community benefit reports for more than a decade, a sign of changing expectations for private health care organizations to explicitly collaborate with public health departments to improve community health. Despite these important changes to practice and policy, no governmental agency provides statistics regarding compliance with this process. To better understand the nature and usefulness of the data provided through these processes, we led a research team that collected and coded Community Health Needs Assessment (CHNA) and Implementation Strategy (IS) Reports for a nationally representative sample of hospitals between 2018 and 2022.

Hospital Community Benefit Reporting: How Group Reporting Practices Limit Accountability.

Objective: To identify the prevalence of group reporting of hospital community benefit efforts to the Internal Revenue Service (IRS) and understand hospital and community characteristics associated with this practice.

Design: The study was based on data collected from publicly available community benefit reports from 2010 to 2019, as well as secondary data from the 2020 American Hospital Association (AHA) Annual Survey. The sample was drawn from the entire nonprofit US hospital population reporting community benefit activities.

Efforts by critical access hospitals to increase health equity through greater engagement with social determinants of health.

Purpose: Greater health care engagement with social determinants of health (SDOH) is critical to improving health equity. However, no national studies have compared programs to address patient social needs among critical access hospitals (CAHs), which are lifelines for rural communities. CAHs generally have fewer resources and receive governmental support to maintain operations.

Hospital adoption of harm reduction and risk education strategies to address substance use disorders.

Hospitals are well-positioned to integrate harm reduction into their workflow. However, the extent to which hospitals across the United States are adopting these strategies remains unknown. To assess what factors are associated with hospital adoption of harm reduction/risk education strategies, and trends of adoption across time.

Trends in the Provision of Community-Building Activities by Nonprofit Hospitals, 2010-2019.

As part of their annual tax report, nonprofit hospitals are asked to report their community-building activities (CBAs); yet, little is known to date about hospitals' spending on such activities. CBAs are activities that improve community health by addressing the upstream factors and social determinants that impact health. Using data from Internal Revenue Service Form 990 Schedule H, this study used descriptive statistics to examine trends in the provision of CBAs by nonprofit hospitals between 2010 and 2019.

Association of Medicaid expansion and 1115 waivers for substance use disorders with hospital provision of opioid use disorder services: a cross sectional study.

Introduction: Opioid-related hospitalizations have risen dramatically, placing hospitals at the frontlines of the opioid epidemic. Medicaid expansion and 1115 waivers for substance use disorders (SUDs) are two key policies aimed at expanding access to care, including opioid use disorder (OUD) services. Yet, little is known about the relationship between these policies and the availability of hospital based OUD programs.

For-Profit Hospital Reflections on Community Relationships in the Time of COVID-19.

Goals: Throughout the COVID-19 pandemic, hospitals and their staffs have been pushed to their limits. Hospitals have had to rethink how they support community health while also providing critical acute care services to combat the morbidity and mortality associated with COVID-19. As anchor institutions, hospitals have a significant effect on not only community health and well-being but also on local economies as primary employers and contractors.