PDF(Pubmed)
Abstract：
OBJECTIVE: Increasingly, healthcare and public health strategists invite us to look at healthcare organisations as not just care providers but as anchor institutions (ie, large community-rooted organisations with significant impact in the local economy, social fabric and overall community well-being). In response, this study explores the mechanisms through which healthcare organisations can impact social determinants of health and communities in their local areas.
METHODS: We conducted case studies with interviews and synthesised the findings using a realist approach to produce a set of explanations (programme theory) of how healthcare organisations can have a positive impact on the overall well-being of local communities by operating as anchor institutions.
METHODS: Secondary healthcare organisations in England, including mental health and community services.
METHODS: Staff from case study sites which were directly employed or actively engaged in the organisation\'s anchor institution strategy. Data collection took place from early June to the end of August 2023.
RESULTS: We found four building blocks for effective anchor activity including employment, spending, estates and sustainability. Healthcare organisations-as anchor institutions-can improve the social determinants of health for their local communities through enabling accessible paths for local community recruitment and career progression; empowering local businesses to join supply chains boosting income and wealth; transforming organisational spaces into community assets; and supporting local innovation and technology to achieve their sustainability goals. These blocks need to be integrated across organisations on the basis of a population health approach promoted by supportive leadership, and in collaboration with a diverse range of local partners.
CONCLUSIONS: Healthcare organisations have the potential for a positive impact on the overall well-being of local communities. Policymakers should support healthcare organisations to leverage employment, spending, estates and sustainability to help address the unequal distribution of the social determinants of health.
METHODS: We conducted case studies with interviews and synthesised the findings using a realist approach to produce a set of explanations (programme theory) of how healthcare organisations can have a positive impact on the overall well-being of local communities by operating as anchor institutions.
METHODS: Secondary healthcare organisations in England, including mental health and community services.
METHODS: Staff from case study sites which were directly employed or actively engaged in the organisation\'s anchor institution strategy. Data collection took place from early June to the end of August 2023.
RESULTS: We found four building blocks for effective anchor activity including employment, spending, estates and sustainability. Healthcare organisations-as anchor institutions-can improve the social determinants of health for their local communities through enabling accessible paths for local community recruitment and career progression; empowering local businesses to join supply chains boosting income and wealth; transforming organisational spaces into community assets; and supporting local innovation and technology to achieve their sustainability goals. These blocks need to be integrated across organisations on the basis of a population health approach promoted by supportive leadership, and in collaboration with a diverse range of local partners.
CONCLUSIONS: Healthcare organisations have the potential for a positive impact on the overall well-being of local communities. Policymakers should support healthcare organisations to leverage employment, spending, estates and sustainability to help address the unequal distribution of the social determinants of health.
摘要：
目标：越来越多，医疗保健和公共卫生战略家邀请我们将医疗保健组织视为不仅是护理提供者，而且是锚定机构(即，对当地经济有重大影响的大型社区组织，社会结构和整体社区福祉)。作为回应,本研究探讨了医疗机构影响当地健康和社区的社会决定因素的机制。
方法：我们通过访谈进行了案例研究，并使用现实主义方法综合了研究结果，以提供一套解释（程序理论），说明医疗机构如何通过作为主要机构运营对当地社区的整体福祉产生积极影响。
方法：英格兰的二级医疗机构，包括心理健康和社区服务。
方法：来自案例研究网站的工作人员直接受雇或积极参与组织的锚定机构战略。数据收集从6月初到2023年8月底进行。
结果：我们发现了有效的锚定活动的四个组成部分，包括就业，消费,地产和可持续性。作为主要机构的医疗保健组织可以通过为当地社区招聘和职业发展提供便利的途径来改善当地社区健康的社会决定因素;赋予当地企业加入供应链以增加收入和财富;将组织空间转化为社区资产;并支持当地创新和技术以实现其可持续发展目标。这些模块需要在支持性领导推动的人口健康方法的基础上跨组织进行整合，并与各种本地合作伙伴合作。
结论：医疗机构有可能对当地社区的整体福祉产生积极影响。政策制定者应该支持医疗保健组织利用就业，消费,遗产和可持续性，以帮助解决健康的社会决定因素的不平等分配问题。
方法：我们通过访谈进行了案例研究，并使用现实主义方法综合了研究结果，以提供一套解释（程序理论），说明医疗机构如何通过作为主要机构运营对当地社区的整体福祉产生积极影响。
方法：英格兰的二级医疗机构，包括心理健康和社区服务。
方法：来自案例研究网站的工作人员直接受雇或积极参与组织的锚定机构战略。数据收集从6月初到2023年8月底进行。
结果：我们发现了有效的锚定活动的四个组成部分，包括就业，消费,地产和可持续性。作为主要机构的医疗保健组织可以通过为当地社区招聘和职业发展提供便利的途径来改善当地社区健康的社会决定因素;赋予当地企业加入供应链以增加收入和财富;将组织空间转化为社区资产;并支持当地创新和技术以实现其可持续发展目标。这些模块需要在支持性领导推动的人口健康方法的基础上跨组织进行整合，并与各种本地合作伙伴合作。
结论：医疗机构有可能对当地社区的整体福祉产生积极影响。政策制定者应该支持医疗保健组织利用就业，消费,遗产和可持续性，以帮助解决健康的社会决定因素的不平等分配问题。
