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Abstract：
We examined the variation in community benefit and charity care reporting standards mandated by states to determine whether state-mandated community benefit and charity care reporting is associated with greater provision of these services.
We used 2011-2019 data from IRS Form 990 Schedule H for 1,423 nonprofit hospitals to create a sample of 12,807 total observations. Random effects regression models were used to examine the association between state reporting requirements and community benefit spending by nonprofit hospitals. Specific reporting requirements were analyzed to determine whether certain requirements were associated with increased spending on these services.
Nonprofit hospitals in states that required reports spent a higher percentage of total hospital expenditures on community benefits (9.1%, SD = 6.2%) compared to states without these requirements (7.2%, SD = 5.7%). A similar association between the percentage of charity care and total hospital expenditures (2.3% and 1.5%) was found. The greater number of reporting requirements was associated with lower levels of charity care provision, as hospitals allocated more resources to other community benefits.
Mandating the reporting of specific services is associated with greater provision of certain specific services, but not all. A concern is that when many services must be reported, the provision of charity care might be reduced as hospitals choose to allocate their community benefit dollars to other categories. As a result, policymakers may want to focus their attention on the services they most want to prioritize.
We used 2011-2019 data from IRS Form 990 Schedule H for 1,423 nonprofit hospitals to create a sample of 12,807 total observations. Random effects regression models were used to examine the association between state reporting requirements and community benefit spending by nonprofit hospitals. Specific reporting requirements were analyzed to determine whether certain requirements were associated with increased spending on these services.
Nonprofit hospitals in states that required reports spent a higher percentage of total hospital expenditures on community benefits (9.1%, SD = 6.2%) compared to states without these requirements (7.2%, SD = 5.7%). A similar association between the percentage of charity care and total hospital expenditures (2.3% and 1.5%) was found. The greater number of reporting requirements was associated with lower levels of charity care provision, as hospitals allocated more resources to other community benefits.
Mandating the reporting of specific services is associated with greater provision of certain specific services, but not all. A concern is that when many services must be reported, the provision of charity care might be reduced as hospitals choose to allocate their community benefit dollars to other categories. As a result, policymakers may want to focus their attention on the services they most want to prioritize.
摘要：
目的：我们研究了各州规定的社区福利和慈善护理报告标准的变化，以确定国家规定的社区福利和慈善护理报告是否与更多提供这些服务相关。
方法：我们使用了1,423家非营利性医院的IRS表格990附表H的2011-2019年数据，创建了总共12,807个观察值的样本。随机效应回归模型用于检查非营利医院的州报告要求与社区福利支出之间的关联。对具体的报告要求进行了分析，以确定某些要求是否与这些服务的支出增加有关。
结果：要求报告的州的非营利医院在社区福利方面的支出占医院总支出的比例更高（9.1％，SD=6.2%)与没有这些要求的州(7.2%，SD=5.7%)。发现慈善护理百分比与医院总支出（2.3％和1.5％）之间存在类似的关联。报告要求的数量越多，慈善护理提供的水平就越低，因为医院将更多的资源分配给其他社区福利。
结论：授权报告特定服务与更多地提供某些特定服务有关，但不是全部。一个令人担忧的问题是，当许多服务必须报告时，由于医院选择将社区福利资金分配给其他类别，慈善护理的提供可能会减少。因此,政策制定者可能希望将注意力集中在他们最想优先考虑的服务上。
方法：我们使用了1,423家非营利性医院的IRS表格990附表H的2011-2019年数据，创建了总共12,807个观察值的样本。随机效应回归模型用于检查非营利医院的州报告要求与社区福利支出之间的关联。对具体的报告要求进行了分析，以确定某些要求是否与这些服务的支出增加有关。
结果：要求报告的州的非营利医院在社区福利方面的支出占医院总支出的比例更高（9.1％，SD=6.2%)与没有这些要求的州(7.2%，SD=5.7%)。发现慈善护理百分比与医院总支出（2.3％和1.5％）之间存在类似的关联。报告要求的数量越多，慈善护理提供的水平就越低，因为医院将更多的资源分配给其他社区福利。
结论：授权报告特定服务与更多地提供某些特定服务有关，但不是全部。一个令人担忧的问题是，当许多服务必须报告时，由于医院选择将社区福利资金分配给其他类别，慈善护理的提供可能会减少。因此,政策制定者可能希望将注意力集中在他们最想优先考虑的服务上。
