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

IF 1.7 3区 医学 Q3 HEALTH POLICY & SERVICES Health Care Management Review Pub Date : 2024-07-01 DOI:10.1097/HMR.0000000000000408
Ashlyn Burns, Valerie A Yeager, Joshua R Vest, Christopher A Harle, Emilie R Madsen, Cory E Cronin, Simone Singh, Berkeley Franz
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Abstract

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.

Methodology: We conducted a content analysis of 83 hospital CHNAs that reported evaluation outcomes drawn from a previously identified 20% random sample ( n = 613) of nonprofit hospitals in the United States. Through qualitative review guided by the CHIEF, we identified and categorized the most common evaluation outcomes reported.

Results: A total of 485 strategies were identified from the 83 hospitals' CHNAs. Evaluated strategies most frequently targeted behavioral health ( n = 124, 26%), access ( n = 83, 17%), and obesity/nutrition/inactivity ( n = 68, 14%). The most common type of evaluation outcomes reported by CHIEF category included system utilization ( n = 342, 71%), system implementation ( n = 170, 35%), project management ( n = 164, 34%), and social outcomes ( n = 163, 34%).

Practice implications: CHNA evaluation strategies focus on utilization (the number of individuals served), with few focusing on social or health outcomes. This represents a missed opportunity to (a) assess the social and health impacts across individual strategies and (b) provide insight that can be used to inform the allocation of limited resources to maximize the impact of community benefit strategies.

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关于社区福利评估的新见解:使用社区健康实施评估框架来评估医院的衡量标准。
背景:非营利性医院必须每 3 年进行一次社区健康需求评估 (CHNA),并制定相应的实施计划。目的:利用社区健康实施评估框架 (CHIEF),我们评估了非营利性医院是否以及如何评估其基于 CHNA 的社区福利措施的影响:我们对 83 家医院的 CHNA 进行了内容分析,这些医院报告的评估结果来自于之前确定的美国 20% 随机抽样(n = 613)的非营利性医院。通过以 CHIEF 为指导的定性审查,我们确定了报告中最常见的评估结果并对其进行了分类:结果:在 83 家医院的 CHNA 中,共确定了 485 项策略。最常见的评估策略是针对行为健康(124 项,占 26%)、就医途径(83 项,占 17%)和肥胖/营养/活动(68 项,占 14%)。按 CHIEF 类别报告的最常见评估结果类型包括系统利用(n = 342,71%)、系统实施(n = 170,35%)、项目管理(n = 164,34%)和社会成果(n = 163,34%):实践意义:CHNA 评估战略侧重于利用率(服务人数),很少关注社会或健康成果。这意味着错失了以下机会:(a) 评估各项战略对社会和健康的影响;(b) 提供可用于指导有限资源分配的见解,以最大限度地发挥社区福利战略的影响。
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来源期刊
Health Care Management Review
Health Care Management Review HEALTH POLICY & SERVICES-
CiteScore
4.70
自引率
8.00%
发文量
48
期刊介绍: Health Care Management Review (HCMR) disseminates state-of-the-art knowledge about management, leadership, and administration of health care systems, organizations, and agencies. Multidisciplinary and international in scope, articles present completed research relevant to health care management, leadership, and administration, as well report on rigorous evaluations of health care management innovations, or provide a synthesis of prior research that results in evidence-based health care management practice recommendations. Articles are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.
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