The public availability of hospital CHNA reports: limitations and potential to study hospital investments in the next phase of public health

Abstract

Nonprofit hospitals have been required to complete and make publicly available their community benefit reports for more than a decade, a sign of changing expectations for private health care organizations to explicitly collaborate with public health departments to improve community health. Despite these important changes to practice and policy, no governmental agency provides statistics regarding compliance with this process. To better understand the nature and usefulness of the data provided through these processes, we led a research team that collected and coded Community Health Needs Assessment (CHNA) and Implementation Strategy (IS) Reports for a nationally representative sample of hospitals between 2018 and 2022. We utilized descriptive statistics to understand the frequency of noncompliance; t-tests and chi-square tests were employed to identify characteristics associated with incomplete documents. Approximately 95% of hospitals provided a public CHNA, and approximately 86% made their IS available. The extent of compliance with the CHNA/IS mandate indicates that these documents, paired with existing public health and policy data, offer considerable potential for understanding the investments nonprofit hospitals make to improve health outcomes and health equity in the communities they serve.