Assessing the validity of self-reported community benefit expenditures: evidence from not-for-profit hospitals in California.
BACKGROUND
In its revised Form 990 Schedule H, the Internal Revenue Service requires not-for-profit hospitals to provide detailed financial information on their community benefits, yet no standardized reporting guidelines exist for how these activities should be quantified. As a result, little is known currently about whether a hospital's self-reported community benefit expenditures provide an accurate picture of its commitment to serving the community.


OBJECTIVE
To assess the validity of hospitals' self-reported community benefit expenditures.


METHODS
Data for this study came from California hospitals. Self-reported community benefit expenditures were derived from hospitals' annual community benefit reports for the year 2009. Bivariate correlation analysis was used to compare self-reported expenditures to a set of indicators of hospitals' charitable activity. Of the 218 private, not-for-profit California hospitals that were required to submit community benefit reports for 2009, 91 (42%) provided sufficient information for our analysis.


RESULTS
California hospitals' self-reported community benefit expenditures were strongly correlated with indicators of charitable activity. Hospitals that reported higher community benefit expenditures engaged in more charitable activities than hospitals that reported lower levels of community benefit spending.


CONCLUSIONS
Expenditure information from California hospitals' community benefit reports was found to be a valid indicator of charitable activity. Self-reported community benefit spending may thus provide a fairly accurate picture of a hospital's commitment to serving its community, despite the lack of standardized reporting guidelines.
Department of Health Systems Administration, Georgetown University, Washington, DC 20057, USA. sr468@georgetown.edu
Simone
S
Rauscher
Mark
M
Vyzas
D000573:American Hospital Association; D000704:Analysis of Variance; D002140:California; D002201:Capital Expenditures / Q000706:statistics & numerical data*; D002608:Charities / Q000706:statistics & numerical data* / Q000639:trends; D003159:Community-Institutional Relations; D030881:Disclosure / Q000592:standards*; D004991:Ethics, Institutional; D055317:Evidence-Based Practice; D005377:Financial Management, Hospital / Q000592:standards*; D019983:Guideline Adherence; D006302:Health Services Research; D006788:Hospitals, Voluntary / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D015980:Public Health Practice / Q000592:standards; D015203:Reproducibility of Results; D013220:State Health Planning and Development Agencies; D019464:Tax Exemption; D017664:Uncompensated Care / Q000706:statistics & numerical data; D014481:United States