National Clinician Scholars Program, University of California, Los Angeles, California (Dr K. L. Chen); Division of General Internal Medicine, Cedars Sinai Medical Center, Los Angeles, California (Dr K. L. Chen); Office of Ambulatory Care, New York City Health + Hospitals, New York City, New York (Drs K. Chen and Lopez); Division of General Internal Medicine and Clinical Innovation (Dr K. Chen) and Department of Population Health (Dr Lopez), New York University School of Medicine, New York City, New York; VA HSR&D Center for the Study of Healthcare Innovation, Implementation, & Policy, West Haven, Connecticut (Dr Holaday); and National Clinician Scholars Program, Yale University, New Haven, Connecticut (Dr Holaday).
J Public Health Manag Pract. 2022;28(2):E615-E618. doi: 10.1097/PHH.0000000000001357.
Although the Affordable Care Act requires nonprofit hospital organizations to report how they identify and invest in community health needs, the utility of mandated reporting documents for tracking investments in the social determinants of health has been questioned. Using public reporting documents and focusing on housing as a social determinant of health, we describe how nonprofit hospital organizations in 5 communities with the highest rates of homelessness document needs and investments related to housing on their Community Health Needs Assessments, Implementation Strategies, and Schedule H (990H) tax forms. Of 47 organizations, 55% identified housing as a health need, 36% described housing-related implementation strategies, and 26% reported relevant 990H spending. Overall concordance among identified needs, strategies, and spending was low, with only 15% of organizations addressing housing across all 3 documents. Regulatory reform could help promote accountability and transparency in organizations' efforts to address housing and other health-related social needs.
尽管《平价医疗法案》要求非营利性医院组织报告其如何识别和投资于社区健康需求，但对于强制性报告文件在跟踪社会决定因素健康投资方面的效用一直存在质疑。本文使用公共报告文件，并以住房作为健康的社会决定因素，描述了在五个无家可归率最高的社区中的非营利性医院组织如何在其社区健康需求评估、实施策略和 Schedule H（990H）税表上记录与住房相关的需求和投资。在 47 家组织中，有 55%将住房确定为健康需求，36%描述了与住房相关的实施策略，26%报告了相关的 990H 支出。在确定的需求、策略和支出之间的总体一致性较低，只有 15%的组织在所有 3 份文件中都涉及住房问题。监管改革可以帮助提高组织解决住房和其他与健康相关的社会需求的努力的问责制和透明度。
