The Prevalence of Community Benefit Participation in the Hospital Region and Its Relationship to Community Health Outcomes

Abstract

The structure of the U.S. health care industry has long emphasized individual outcomes, but there is a growing recognition that hospitals may be able to provide more cost-effective care through community-focused initiatives. Few assessments have been established to measure outcomes of these increasing community benefit efforts. This study uses the rate of ambulatory care sensitive condition admissions in the Medicare population as a mechanism for understanding the effectiveness of a range of hospital community benefit practices. This study is based on national data collected through the American Hospital Association Annual Survey for the years 2004, 2006, 2008, and 2010 and supplemented by demographic, region, and policy information collected from other sources. The outcome measure and the region definition are established through the Dartmouth Atlas of Health Care. Multilevel mixed-effects linear regression modeling is used to analyze the relationship between community benefit participation levels within a region and the region's ambulatory care sensitive condition prevalence.

Community health education was found to be associated with a reduced prevalence of ambulatory care sensitive conditions (ACSCs). ACSC rates were also connected to several other factors, including health needs and demographic characteristics in a region. The finding that community education appears to have the greatest link to limiting ACSC admissions is in line with other studies showing community education initiatives to be effective in improving health outcomes. This may be particularly important for hospitals seeking to best direct their resources in a way that addresses broader community health outcomes.