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AbstractThis article explores selected fundraising information for charitable
nonprofits, asking whether widespread abuses might exist
in this sector. After examining the pervasiveness of fundraising
and its relation to mission, we show that a few nonprofits raise
a majority of sector charitable revenues, and we present the
ratio of funds raised to funds spent on fundraising by mission
categories. We find that 72 percent of charitable nonprofits do
not report direct fundraising expenditures, 5 percent of the active
fundraising nonprofits obtain 90 percent of total funds raised,
mission is related to a nonprofit's ability to raise funds, the
median nonprofit spends about 9.6 percent of total raised funds
for fundraising, and only one in five nonprofits hires a professional
fundraiser. At least in terms of the measures used in this
report, widespread abuses are not obvious.

AbstractLittle is known about why nonprofits accrue debt, how much they owe, and whether the funds they borrow are used productively. This article distinguishes between productive, problematic, and deferred debt. Employing a data base representative of 114,726 tax‐filing charitable nonprofits in the United States in 1986, it examines the pervasiveness of nonprofit debt and the relation between this debt and nonprofit financial health. The analysis finds that over 70 percent of the nonprofits hold debt, the distribution of this debt is highly concentrated, and the level of debt and leverage varies with asset size and type of activity. Nonprofits with higher leverage and absolute debt levels are financially healthier than those with lower levels. While the analysis does not determine whether financially stronger nonprofits are better able to borrow, the results support the view that borrowing in the nonprofit sector is economically efficient.

This article defines a charitable nonprofit organization as financially vulnerable if it is likely to cut service offerings immediately when a financial shock occurs. It discusses why the vulnerability of the nonprofit sector is of interest to researchers, explores the destabilizing role of third-party finance, considers the reasons for the lack of research on vulnerability, and presents a conceptual framework for identifying finan cially vulnerable nonprofits. Four vulnerability criteria are defined and applied to a 1983 national sample of tax returns filed by 4,730 U.S. charitable nonprofits. The financial data of at-risk organizations are then analyzed to discern the characteristics of vulnerable and other nonprofit organizations.

AbstractMost theories of nonprofit behavior assume that nonprofit managers run surpluses only temporarily and that managers choose a budget level equal to expected revenues. In reality, equity accumulations have intrinsic value to nonprofit managers, and equity balances of nonprofits do grow over time. The authors discuss the tax treatment of nonprofits under U.S. tax laws, present existing theories of nonprofit behavior, and consider the reasons a prudent nonprofit manager might wish to earn and retain surplus funds. Data from a 1983 national sample of nonprofits are used to show that a large majority of nonprofits earned surpluses in 1983, that surprisingly few nonprofits had surpluses close to the zero level, and that the size of a nonprofit's surplus was related to its equity and asset holdings.

This study examined effects of race and insurance on the risk of potentially avoidable hospitalizations (PAHs) in Tennessee. Applying the current Agency for Healthcare Research and Quality definitions for ambulatory-care-sensitive conditions to inpatient discharge data, the study found hospitalized Black patients more likely than their White counterparts to have experienced a PAH for chronic conditions. In contrast, Black inpatients' risk was lower than that of White inpatients for acute conditions after controlling for covariates. The results also showed the strong influence of insurance coverage. Finally, an analysis of racial differences in the relative risks for PAHs using data grouped by insurance status showed that hospitalized Blacks within each subset had a greater risk of having a PAH than hospitalized Whites, although the risk varied with insurance type. The variations of PAH risks across racial and insurance categories, together with the extra risks associated with chronic conditions, deserve greater examination.

Purpose The current study investigates associations between mHealth apps and healthcare decision-making and health communication among informal caregivers in the US. Design Cross-sectional study employing secondary data. Setting The Health Information National Trends Survey (HINTS5, Cycles 2 through 4, 2018 – 2020). Sample Self-identified informal caregivers (n = 1386; had mHealth apps = 61.3%, female = 63.2%, some college or more in education = 80.3%) who reported owning at least a smartphone or a tablet computer (i.e., ownership of a "smart device"). Measures Sociodemographic characteristics, reports of having mHealth apps, smart device utilization in healthcare decision-making and health communication. Analysis Accounting for the complex design features of the HINTS data, we constructed multiple hierarchical logistic regressions to compute adjusted odds ratios (aOR) and their 95% confidence intervals (CI). Results Compared to caregivers without mHealth apps, those with the apps had higher odds of utilizing their smart devices to make a health-related decision, such as how to treat a disease or a medical condition (aOR = 1.65; 95% CI: 1.13-2.39, P < .01), or engage in health-related discussions with a healthcare provider (aOR = 2.36; 95% CI: 1.54-3.61, P < .001). Conclusion Having mHealth apps was associated with a higher likelihood of using smart devices in healthcare decision-making and health communication by informal caregivers. Empowering caregivers to make informed health-related decisions and communicate effectively with healthcare providers are both crucial to health promotion and well-being. Future studies should investigate facilitators as well as barriers to using mHealth apps and smart devices in health-promoting strategies involving informal caregivers.

Medicare Part D improved medication adherence among the elderly, but to date, its effect on disparities in adherence remains unknown. We estimated Part D impact on racial/ethnic disparities in adherence to cardiovascular medications among seniors, using pooled data from the Medical Expenditure Panel Survey (2002-2010) on 14,221 Medicare recipients (65+ years) and 3,456 near-elderly controls (60-64 years). Study sample included White, Black, or Hispanic respondents who used at least one cardiovascular medication. Twelve-month adherence was measured as having an overall proportion of days covered ≥80%. Adherence disparities were defined according to the Institute of Medicine framework. Using difference-in-differences logistic regression, we found Part D to be associated with a 16-percentage-point decrease in the White–Hispanic disparity in overall adherence among seniors, net of the change among controls. Black–White disparities worsened only among men, by 21 percentage points. Increasing access and improving quality of medication use among disadvantaged seniors should remain a policy priority.