Role of the hospital in assessing community health needs

Background: U.S. hospital are transforming to address socioeconomoic and environmental issues that affect the health of their communities. The community health needs assessment and implementation plan processes can serve as a platform to stimulate hospitals’ community collaborations. As health care and public health become better aligned, it is important to gain insight into the roles hospitals are playing as they address community health concerns.

Methods: Approximately 2,700 CHNAs and CHIPs were collected from hospital websites. From that population, 300 were selected through stratified random sampling. Qualitative content analysis was conducted to identify methodology, prioritization process, community needs, partnerships and interventions. Code frequency and co-occurrences were calculated. A Literature review and interviews with hospital-based community health leaders were also conducted.

Results: The top drivers of community health needs were: access to care, preventive services, chronic disease management and socioeconomic insecurity. The most commonly identified health conditions of concern were: obesity, behavioral health, substance abuse, diabetes and cancer. A majority of hospitals worked collaboratively with local public health departments on their CHNAs. While some hospitals developed comprehensive plans to address community health needs, others took a more traditional, hospital-based approach.

Discussion: The extent to which hospitals are involved in community health improvement varies, but there is a clear trend toward addressing public health goals.  The primary factors impacting a hospital’s role in community health were: 1) degree of collaboration; 2) leadership engagement; and 3) focus of interventions. These facets contribute to a model characterizing potential hospital roles as they engage in population health.