Accreditation intent, community health assessments, and local health department-hospital collaboration

Abstract

Background: Community health assessments (CHAs) are among the most core of activities conducted by local health departments (LHDs), and many LHDs have been conducting CHAs on a regular basis for years. More recently, completing a CHA has also become a prerequisite for LHDs seeking accreditation by the Public Health Accreditation Board (PHAB). Similarly, under the Affordable Care Act, tax-exempt hospitals are required to conduct periodic community health needs assessments. Opportunities thus exist for LHDs and tax-exempt hospitals to engage in collaborations related to CHAs. Yet, it remains unclear whether interest in PHAB accreditation provides incentive to LHDs to engage in collaborations with hospitals around community health assessment and improvement planning. Methods: Using data from the 2013 National Association of County and City Health Officials (NACCHO) Profile study, LHD-hospital collaborations related to CHAs were examined, including characteristics of LHDs involved in such collaborations and the relationships between LHDs’ level of engagement with accreditation activities and their involvement in collaborations with hospitals. Results: LHDs that collaborate with hospitals on CHAs are larger, have higher total and per capita expenditures, and are more likely to be locally governed and to have a local board of health. Three PHAB prerequisites—completion of a CHA, completion of a community health improvement plan, and completion of an agency-wide strategic plan within the previous 5 years—were all significantly correlated (p<0.01) with LHD-hospital collaborations, suggesting that accreditation efforts may be a positive influence on collaborations. Implications: Policymakers could provide incentive for voluntary accreditation to encourage greater collaboration between LHDs and hospitals around CHAs.