332787
Variation in Process and Priorities between Local Health Department and Hospital Led Community Health Assessments
Tuesday, November 3, 2015
Scott Frank, MD, MS,
Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH
Alexandria Drake, MPH,
Ohio Research Association for Public Health Improvement, Case Western Reserve University, Cleveland, OH
Purpose: Contrast and compare the process and health priorities involving Local Health Department (LHD) led Community Health Assessments (CHA) and Community Health Improvement Plans (CHIP); and Hospital led Community Health Needs Assessments (CHNA) and Community Health Needs Improvement Strategies (CHNIS). Methods: This comparative case study was conducted using quantitative and qualitative data abstracted from publicly available CHA/CHIP and CHNA/CHNIS utilizing version of the Wisconsin CHIPP Quality Measurement Tool adapted to also address CHNA/CHNIS; and identified priorities. All Ohio LHDs (n= 125) and hospital systems (n=170) were included. Results: Top hospital priorities were: obesity (69%); access to medical care (59%); mental health (59%); substance abuse treatment (55%); and heart disease (53%). Top LHDs priorities were: substance abuse prevention and treatment (both 70%); access to medical care and behavioral health (both 70%); youth development/school health (68%); physical activity (65%); and nutrition (57%). LHD assessments were more likely than hospitals to include implementation planning (59% vs 47%); utilize a formal model (75% vs 19%); define a mission or vision (81% vs 19%); have broad stakeholder representation (LHD 91%, Hospital 67%); use evidence informed strategies (64% vs 22%); and conduct health policy activity (58% vs 14%). Hospitals were more likely to address health disparities (65% vs 38%); and describe community assets (87% vs 37%). Conclusion: Meaningful variations in process and priorities exist between LHDs and hospitals. Hospital led CHNA/CHNIS highlighted medical diagnoses and health systems characteristics while LHD led CHA/CHIP focused on behavioral factors and community conditions that contribute to development or persistence of the medical and health systems problems. The LHD process was more grounded in theoretical and evidence based frameworks and more inclusive. Hospitals were more likely to address community assets and health equity. These differences appear complementary, implying the population health needs may be more effectively served through a collaborative process.
Learning Areas:
Administration, management, leadership
Clinical medicine applied in public health
Planning of health education strategies, interventions, and programs
Public health administration or related administration
Public health or related research
Learning Objectives:
Compare the community health assessment process and health priorities identified by LHD led Community Health Assessments (CHAs) or Community Health Improvement Plans (CHIPs); and by Hospital led Community Health Needs Assessments (CHNAs) or Community Health Needs Improvement Strategies (CHNIS).
Keyword(s): Community Health Assessment, Quality Improvement
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am Principal investigator of the Ohio public health practice-based research network; health commissioner of the Shaker Heights Health Department; and director of the Master of Public Health Program at Case Western Reserve University.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
