College of Public Health, Ohio State University, Columbus, USA.
J Healthc Manag. 2013 Mar-Apr;58(2):126-41; discussion 141-2.
Not-for-profit (NFP) hospitals have come under increased public scrutiny for management practices that are inconsistent with their charitable focus. Of particular concern is the amount of community benefit provided by NFP hospitals compared to for-profit (FP) hospitals given the substantial tax benefits afforded to NFP hospitals. This study examines hospital ownership and community benefit provision beyond the traditional uncompensated care comparison by using broader measures of community benefit that capture charitable services, community assessment and partnership, and community-oriented health services. The study sample includes 3,317 nongovernment, general, acute care, community hospitals that were in operation in 2006. Data for this study came from the 2006 American Hospital Association Hospital Survey and the 2006 Area Resource File. We used multivariate regression analyses to examine the relationship between hospital ownership and five indicators of community benefit, controlling for hospital characteristics, market demand, hospital competition, and state regulations for community benefit. We found that NFP hospitals report more community benefit activities than do FP hospitals that extend beyond uncompensated care. Our findings underscore the importance of defining and including activities beyond uncompensated care when evaluating community benefit provided by NFP hospitals.
非营利性 (NFP) 医院因其管理做法不符合慈善宗旨而受到越来越多的公众审查。特别令人关注的是，与营利性 (FP) 医院相比，NFP 医院提供的社区福利数量，考虑到 NFP 医院享有的大量税收优惠。本研究通过使用更广泛的社区福利衡量标准，超越了传统的无偿护理比较，考察了医院所有权和社区福利的提供情况，这些衡量标准包括慈善服务、社区评估和伙伴关系以及面向社区的卫生服务。研究样本包括 2006 年运营的 3317 家非政府、普通、急性护理、社区医院。本研究的数据来自 2006 年美国医院协会医院调查和 2006 年地区资源文件。我们使用多元回归分析来检验医院所有权与社区福利五个指标之间的关系，同时控制医院特征、市场需求、医院竞争和社区福利的州法规。我们发现，NFP 医院报告的社区福利活动比 FP 医院多，这些活动超出了无偿护理。我们的研究结果强调了在评估 NFP 医院提供的社区福利时，定义和包括无偿护理以外的活动的重要性。
