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医院社区福利报告:集团报告实践如何限制问责制
Cory E Cronin1, Simone Singh, Neeraj Puro
1Department of Social and Public Health, Ohio University College of Health Sciences and Professions, Athens, Ohio (Dr Cronin); Appalachian Institute to Advance Health Equity Science, Ohio University, Athens, Ohio (Drs Cronin and Franz); Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan (Dr Singh); Management-Health Administration, Florida Atlantic University College of Business, Boca Raton, Florida (Dr Puro); and Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio (Dr Franz).
超过40%的美国医院在2010-2019年间一直报告社区福利作为一个群体. 这种做法阻碍了医院社区福利支出的问责制和准确评估.
科学领域:
- 医疗保健管理的管理
- 公共卫生政策 公共卫生政策
- 卫生经济学 卫生经济学
背景情况:
- 医院有义务向国税局 (IRS) 报告社区福利支出.
- 集团报告,即多家医院作为单一实体报告,是一种已经出现的做法.
- 集团报告对透明度和问责制的影响仍然不清楚.
研究的目的:
- 为了确定医院社区向国税局报告医院社区利益的群体报告的普遍性.
- 确定与组报告相关的医院和社区特征.
- 评估集团报告对问责制和准确支出评估的影响.
主要方法:
- 对2010-2019年公开可用的社区福利报告 (IRS Form 990 Schedule H) 的分析.
- 利用了2020年美国医院协会 (AHA) 年度调查的二次数据.
- 采用了美国非营利性医院人口的描述性统计和双变量分析.
主要成果:
- 在2010年至2019年期间,超过40%的医院参与了小组报告,许多医院一直在这样做.
- 医院系统的成员资格和更大的医院规模与小组报告有积极的关联.
- 国家层面的社区福利政策与小组报告的较低流行率有关.
结论:
- 集体报告的高普及率可能会破坏社区问责制和对社区福利支出的准确评估.
- 当前的报告实践可能与社区利益政策的预期目标不一致.
- 报告法规的修改是必要的,以提高透明度并确保政策的有效性.
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