Non‐profit hospitals are important anchors in Appalachian communities, in part because of the concentration of health care dollars within these institutions. Community benefit efforts of these hospitals, therefore, have the potential to fill gaps in public health and social service provision in underserved areas with documented health disparities and access barriers. To date, however, we do not fully understand how community benefit practices vary by hospital setting. Employing hierarchical linear modeling using a multilevel mixed‐effects approach, this study analyzes data from the years 2010 to 2016 to assess community benefit practices and spending between hospitals in Appalachia and non‐Appalachian counties. Findings indicate that hospitals within Appalachian counties, and rural hospitals in this region, in particular, spent less on community benefit than hospitals, not in this region. Given the potential for community benefit to impact health outcomes and access to care, this disparity is important to state and local public health efforts and suggests the need for additional support for hospitals to engage their communities around critical health needs.

中文翻译：

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农村阿巴拉契亚地区的医院社区收益：还有一个缺口*

非营利性医院是阿巴拉契亚社区的重要支柱，部分原因是这些机构中医疗保健费用的集中。因此，这些医院的社区福利努力有潜力用有文件证明的卫生差距和进入障碍来填补服务水平不足地区的公共卫生和社会服务差距。但是，到目前为止，我们还没有完全了解社区福利实践因医院环境而异。本研究采用多层次混合效应方法进行分层线性建模，分析了2010年至2016年的数据，以评估阿巴拉契亚县和非阿巴拉契亚县医院之间的社区福利实践和支出。调查结果表明，阿巴拉契亚县内的医院，尤其是该地区的乡村医院，在社区福利方面的花费比在医院少，而不是在该地区。鉴于社区受益的潜力可能会影响健康结果和就医机会，这种差距对于州和地方公共卫生工作非常重要，并建议需要更多的支持，以使医院围绕关键的医疗需求参与社区活动。