Apatu, Emma

Abstract Aims To determine if there is an association between better County Health Rankings and the increased odds of a hospital gaining Magnet designation in subsequent years (2014–2019) compared with counties with lower rankings. Background The Magnet hospital model is recognized to have a great effect on nurses, patients and organizational outcomes. Although Magnet hospital designation is a well‐established structural marker for nursing excellence, the effect of County Health Rankings and subsequent hospital achievement of Magnet status is unknown. Design A descriptive, cross‐sectional quantitative approach was adopted for this study. Methods Data were derived from 2010 to 2019 U.S. County Health Rankings, American Hospital Association, and American Nursing Credentialing Center databases. Logistic regression models were utilized to determine associations between county rankings for health behaviours, clinical care, social and economic factors, physical environment and counties with a new Magnet hospital after 2014. Results Counties with the worst rankings for clinical care and socio‐economic status had reduced odds of obtaining a Magnet hospital designation compared with best‐ranking counties. While middle‐ranking counties for the physical environment ranking had increased odds of having Magnet designation compared with best‐ranking counties. Additionally, having an increased percent of government non‐federal hospital or a higher percentage of critical access hospitals in the county reduced the odds of having a Magnet‐designated facility after 2014. Conclusion The findings underscore the important associations between Magnet‐designated facilities’ location and the health of its surrounding counties. This study is the first to examine the relationship between County Health Rankings and a hospital's likelihood of obtaining Magnet status and points to the need for future research to explore outcomes of care previously identified as improved in Magnet‐designated hospitals. Implications Recognizing the benefits of Magnet facilities, it is important for health care leaders and policy makers to seek opportunities to promote centres of excellence in higher need communities through policy and financial intervention.

Hospitals are expected to fulfill a role in the communities they serve by improving the health of the population in the community as mandated in the Affordable Care Act. One way hospitals achieve this is to create partnerships with diverse organizations, such as local public health departments, state/federal agencies, and other health care organizations. The aim of this study is to examine characteristics of hospitals that developed partnerships based on improving population health. This study utilized the 2015 Population Health Survey, American Hospital Association Database, and Dartmouth Atlas of Health Care. Hospital characteristics included size, ownership status, part of a system, teaching status location, Medicare percentage, Medicaid percentage, average stay length, and inpatient days per 1000 persons. Level of partnership was measured by the hospital's current working relationship with other hospitals/health care systems or local/state/other agencies. Univariate, bivariate, and multivariate regression analyses were used to analyze the relationship between hospital partnerships and organizational characteristics. Hospitals with strong relationships tend to be larger and not-for-profit hospitals, hospitals with system members and located in urban areas, and teaching-affiliated hospitals. This study also found hospital characteristics were related to hospitals' partnerships. Hospitals within health care systems and with high inpatient volume were more likely to report relationships that were stronger. This study provides a systematic and updated look at hospitals' partnership when looking at commitment to population health improvement and contributes to the literature by informing about the greater need to support rural and smaller hospitals with population health outreach activities.

Abstract Background Community engagement is commonly used to address social inequities. The Carnegie Foundation offers an optional designation for which U.S. colleges and universities may apply to facilitate better educational outcomes through the institutionalization of community engagement. This study is the first to examine the relationship between Carnegie community engaged status and community health outcomes. Methods Ordinal logistic regression was conducted to investigate the association between the presence of a community engaged institution and county health outcomes, including health behaviors, clinical care relating to access and quality, social and economic factors, and physical environment from the 2016 Robert Wood Johnson County Health Rankings and 2015 New England Resource Center for Higher Education Community engaged list. We examined 820 U.S. counties containing a university or college, 240 of which had a community engaged designation. Results Findings indicated that the presence of a community-engaged institution was positively associated with Clinical Care (OR = 1.99; 95% CI: 1.09, 3.64). Other county health factors were not similarly associated. Conclusions Our findings suggest that community engagement status may be most relevant for achieving better access and quality of clinical care. More research is needed to explore this association in the U.S. and internationally.

SummaryThe shift from a fee‐for‐service payment to a value‐based payment scheme, sparked by the Patient Protection and Affordable Care Act, introduced pay‐for‐performance programs such Hospital Value Based Purchasing. Previous inquiry has not considered how local community factors may affect hospital system performance. This study investigated the association between local health performance and minority population in a hospital referral region (HRR). The primary objective was to ascertain whether community diversity levels are significantly associated to local health performance guided by the ecological model. Secondary data analysis collected from the 2016 American Hospital Association, Area Health Resource File, Commonwealth Fund Scorecard on Local Health System Performance, and the Dartmouth Atlas HRR dataset was used. Our primary findings show that the more diverse a HRR is, the more likely it is to be associated with lower ranking for access and affordability prevention and treatment avoidable hospital use and cost as well as healthy lives. Total performance score was significantly related to a better health ranking on prevention and treatment, hospital use, and cost, as well as healthy lives. This research supports the assertion that communities, particularly minorities in those communities, affect local health care performance in a variety of ways.