title: Community benefits provided by religious, other nonprofit, and for-profit hospitals: a longitudinal analysis 2000-2009.
abstract: BACKGROUND
  Nonprofit hospitals (NFPs) are expected to provide community benefits to justify the tax benefits they receive, but recent budgetary constraints have called into question the degree to which the tax benefits are justified. The empirical literature comparing community benefits provided by NFPs and their for-profit counterparts is mixed. However, NFPs are not a homogenous group and can include religious hospitals, community-owned hospitals, or academic medical centers.
  
  
  OBJECTIVE
  This longitudinal study examines how religious hospitals compare with other NFPs and for-profit hospitals with respect to providing community benefits and how the provision of community benefits by hospitals has changed over time.
  
  
  METHODS
  Using a pooled cross-sectional design, we examine two summated scores based on questions from the American Hospital Association annual survey that focus on community orientation among hospitals. We analyze two regressions with year, facility, and market controls to determine how religious hospitals compare with the other groups over time.
  
  
  RESULTS
  Overall, 11% of U.S. hospitals are religious. Religious hospitals were more likely to engage in each individual community benefit activity examined. In addition, the mean values of community benefits provided by religious hospitals, as measured on two summated scores, were significantly higher than those provided by other hospital types in bivariate and regression analyses. Overall, community benefits provided by all hospitals increased over time and then leveled off during the start of the recent economic downturn.
  
  
  CONCLUSIONS
  As the debate continues regarding federal tax exemption status, policymakers should consider religious hospitals separately from NFPs. Managers at religious hospitals should consider how their increased levels of community benefits are related to their missions and set benchmarks that recognize and communicate those achievements.
authors.affiliation: Alva O. Ferdinand, JD, MPH, is Doctoral Candidate, Department of Health Care Organization and Policy, University of Alabama at Birmingham. Josué Patien Epané, MBA, is Doctoral Candidate, Department of Health Services Administration, University of Alabama at Birmingham. Nir Menachemi, PhD, MPH, is Professor and Doctoral Program Director, Department of Health Care Organization and Policy, University of Alabama at Birmingham. E-mail: nmenachemi@uab.edu.
authors.forename: Alva O
authors.initials: AO
authors.lastname: Ferdinand
authors.forename: Josue Patien
authors.initials: JP
authors.lastname: Epane
authors.forename: Nir
authors.initials: N
authors.lastname: Menachemi
mesh_terms: D003159:Community-Institutional Relations; D003430:Cross-Sectional Studies; D006742:Hospital Bed Capacity; D006777:Hospitals, Proprietary / Q000458:organization & administration* / Q000706:statistics & numerical data; D016519:Hospitals, Religious / Q000458:organization & administration* / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000458:organization & administration / Q000706:statistics & numerical data; D006788:Hospitals, Voluntary / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D014481:United States / Q000453:epidemiology