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Provision of Social Care Services by US Hospitals.
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- Author(s): IOTT, BRADLEY; ANTHONY, DENISE
- Source:
Milbank Quarterly. Jun2023, Vol. 101 Issue 2, p601-635. 35p. 8 Charts, 1 Graph. - Source:
- Additional Information
- Subject Terms: HOSPITALS; HEALTH policy; TAXATION; PROPRIETARY health facilities; HEALTH education; SOCIAL determinants of health; NONPROFIT organizations; FOOD relief; HOSPITAL utilization; MULTIVARIATE analysis; MEDICAL care; HOSPITAL costs; HEALTH fairs; TRANSPORTATION of patients; PEARSON correlation (Statistics); PUBLIC housing; INTERPROFESSIONAL relations; COMMUNITY-based social services; DESCRIPTIVE statistics; CHI-squared test; HEALTH insurance; SOCIAL services; DATA analysis software; SECONDARY analysis; POISSON distribution
- Subject Terms:
- Abstract: Policy PointsHospitals address population health needs and patients' social determinants of health by offering social care services. Tax‐exempt hospitals are required to invest in community benefits, including social care services programs, though most community benefits spending is toward unreimbursed health care services.Tax‐exempt hospitals offer about 36% more social care services than for‐profit hospitals. Among tax‐exempt hospitals, those that allocate more resources to community benefits spending offer more types of social care services, but those in states with minimum community benefits spending requirements offer fewer social care services.Policymakers may consider specifically incentivizing community benefits expenditures toward particular social care services, including linking tax exemptions to implementation, utilization, and outcome targets, to more directly help patients. Context: Despite growing interest in identifying patients' social needs, little is known about hospitals' provision of services to address them. We identify social care services offered by US hospitals and determine whether hospital spending or state policies toward community benefits are associated with the provision of these services by tax‐exempt hospitals. Methods: National secondary data about hospitals were collected from the American Hospital Association Annual Survey, with additional Internal Revenue Service (IRS) Form 990 data on community benefits spending from CommunityBenefitInsight.org and state‐level community benefits policies from HilltopInstitute.org. Descriptive statistics for types of social care services and hospital characteristics were calculated, with bivariate chi‐square and t‐tests comparing for‐profit and tax‐exempt hospitals. Multivariable Poisson regression was used to estimate associations between hospital characteristics and types of services offered and among tax‐exempt hospitals to estimate associations between social care services and community benefits spending and policies. Multivariable logistic regressions modeled associations between community benefits spending/policies and each type of social care services. Findings: Private US hospitals offered an average of 5.7 types of social care services in 2018. Tax‐exempt hospitals offered about 36% more social care services than for‐profit hospitals. Larger number of beds, health system affiliation, and having community partnerships are associated with more social care services, whereas rural hospitals and those managed under contract offered fewer social care services. Among tax‐exempt hospitals, greater community benefits spending is associated with offering more total (incidence rate ratio [IRR] = 1.10, p < 0.01) and patient‐focused social care services (IRR = 1.16, p < 0.01). Hospitals in states with minimum community benefits spending requirements offered significantly fewer social care services. Conclusions: Although tax‐exempt status and increased community benefits spending were associated with increased social care services provision, the observation that certain hospital characteristics and state minimum community benefits spending requirements were associated with fewer social care services suggests opportunities for policy reform to increase social care services implementation. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Milbank Quarterly is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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