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Abstract
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<h5 class="section-title" id="d3735291e161">Objectives</h5>
<p id="d3735291e163">To investigate whether tax‐exempt hospitals' investments in community
health are associated
with patterns of governmental public health spending focusing specifically on the
relationship between hospitals' community benefit expenditures and the spending patterns
of local health departments (LHDs).
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<h5 class="section-title" id="d3735291e166">Study Design</h5>
<p id="d3735291e168">We combined data on tax‐exempt hospitals' community benefit spending
with data on
spending by the corresponding LHD that served the county in which a hospital was located.
Data were available for 2 years, 2009 and 2013. Generalized linear regressions were
estimated with indicators of hospital community benefit spending as the dependent
variable and LHD spending as the key independent variable.
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<h5 class="section-title" id="d3735291e171">Principal Findings</h5>
<p id="d3735291e173">Hospital community benefit spending was unrelated to how much
local public health
agencies spent, per capita, on public health in their communities.
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<h5 class="section-title" id="d3735291e176">Conclusions</h5>
<p id="d3735291e178">Patterns of local public health spending do not appear to impact
the investments of
tax‐exempt hospitals in community health activities. Opportunities may, however, exist
for a more active engagement between the public and private sector to ensure that
the expenditures of all stakeholders involved in community health improvement efforts
complement one another.
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The Patient Protection and Affordable Care Act (ACA) requires tax-exempt hospitals to conduct assessments of community needs and address identified needs. Most tax-exempt hospitals will need to meet this requirement by the end of 2013.
We investigated whether federally tax-exempt hospitals consider community health needs when deciding how much and what types of community benefits to provide.