Suchergebnisse

OBJECTIVE: To compare hospital‐community partnerships among safety‐net hospitals relative to non–safety‐net hospitals, and explore whether hospital‐community partnerships are associated with reductions in readmission rates. DATA SOURCES: Data from four nationwide hospital‐level datasets for 2015‐2016, including American Hospital Association (AHA) annual survey, Hospital Inpatient Prospective Payment System (IPPS) data, CMS Hospital Compare, and County Health Rankings National (CHRN) data. STUDY DESIGN: We first examined how safety‐net hospitals partner with nine different community providers, and how the overall and individual partnership patterns differ from those in non–safety‐net hospitals. We then explored their association with 30‐day readmission rates by diagnosis and hospital wide. DATA COLLECTION/EXTRACTION METHODS: We included 1979 hospitals across 50 US states. PRINCIPAL FINDINGS: Safety‐net hospitals were more engaged in hospital‐community partnerships, especially with local public health, local governments, social services, nonprofits, and insurance companies, relative to their non–safety‐net peers. However, we found that such partnerships were not significantly related to reductions in readmission rates. The findings indicated that merely partnering with various community organizations may not be associated with readmission rate reduction. CONCLUSIONS: Before promoting partnerships with various community organizations for its own sake, further prospective, longitudinal, and evidence‐based guidance derived from the study of hospital‐community partnerships is needed to make meaningful recommendations aimed at readmission rate reduction in safety‐net hospitals.

Fundamental to democratic societies, citizen participation is an important tool for promoting active, informed, and empowered citizenry as well as responsive and accountable administration. Past literature on citizen participation has focused on its determinants, forms, and prevalence. This study examines the relationship between a specific form of citizen participation—client participation—and organizational performance. We use hybrid data on U.S. nursing homes that combine a survey of nursing home administrators' managerial practices with federal performance appraisal data. Our empirical findings suggest that more intense levels of client participation, such as the use of clients' feedback in decision-making, are positively associated with performance: They increase the overall five-star ratings and lower health deficiencies. In contrast, less intense client participation efforts, such as merely communicating with client/family groups, are not significantly related to performance. This study highlights the role of participation intensity, suggesting that public administrators should not only go beyond informing and listening to their stakeholders, but also take steps to use the obtained feedback in organizational decision-making.