Hospital-Community Engagement, Community Collective Efficacy and Rural Critical Access Hospital Reputation

Abstract

Background

Critical Access Hospitals (CAHs) are small rural hospitals that often experience a lower community reputation than other hospitals. Community engagement efforts by CAHs can potentially improve community perceptions of their local hospital. However, empirical evidence on this is lacking. To fill this evidence gap, this study sought to assess the relationship between hospital-community engagement and perceived hospital reputation in communities with CAHs in Georgia.

Methods

Data for this study were obtained from a survey of 328 residents of 24 (of the 30) Georgia rural counties with a CAH, using a random stratified sampling approach. A 3-item scale, assessing the collaboration & shared leadership dimension of community engagement was used to measure hospital-community engagement. Service quality and social responsibility reputation were assessed using 4-item and 3-item scales, respectively. Assessed covariates included sociodemographic factors such as sex, race, age, education, hospital use, insurance coverage and general health status. Data were analyzed using survey-weighted multivariable linear regression. The analytic model also examined the moderating role of community collective efficacy - (i.e., communities’ capacity to come today and solve community issues; measured with a 3-item scale) - in the relationship between hospital-community engagement and hospital reputation.

Results

The hospital-community engagement dimension of collaboration & shared leadership was positively associated with service quality reputation (b=0.273; 95% CI=0.174 - 0.373; p<0.001) and social responsibility reputation (b=0.306; 95% CI=0.132 - 0.481; p=0.001). A positive interaction effect was observed (b=0.271; 95% CI=0.045 - 0.497; p=0.019), such that the relationship between collaboration & shared leadership and social responsibility reputation was more pronounced in communities with high collective efficacy.

Conclusion

By actively engaging their communities, rural hospitals can improve their reputation regarding the quality of services and their social responsibility.

Keywords

rural; hospitals; community engagement; organizational reputation

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Hospital-Community Engagement, Community Collective Efficacy and Rural Critical Access Hospital Reputation

Background

Critical Access Hospitals (CAHs) are small rural hospitals that often experience a lower community reputation than other hospitals. Community engagement efforts by CAHs can potentially improve community perceptions of their local hospital. However, empirical evidence on this is lacking. To fill this evidence gap, this study sought to assess the relationship between hospital-community engagement and perceived hospital reputation in communities with CAHs in Georgia.

Methods

Data for this study were obtained from a survey of 328 residents of 24 (of the 30) Georgia rural counties with a CAH, using a random stratified sampling approach. A 3-item scale, assessing the collaboration & shared leadership dimension of community engagement was used to measure hospital-community engagement. Service quality and social responsibility reputation were assessed using 4-item and 3-item scales, respectively. Assessed covariates included sociodemographic factors such as sex, race, age, education, hospital use, insurance coverage and general health status. Data were analyzed using survey-weighted multivariable linear regression. The analytic model also examined the moderating role of community collective efficacy - (i.e., communities’ capacity to come today and solve community issues; measured with a 3-item scale) - in the relationship between hospital-community engagement and hospital reputation.

Results

The hospital-community engagement dimension of collaboration & shared leadership was positively associated with service quality reputation (b=0.273; 95% CI=0.174 - 0.373; p<0.001) and social responsibility reputation (b=0.306; 95% CI=0.132 - 0.481; p=0.001). A positive interaction effect was observed (b=0.271; 95% CI=0.045 - 0.497; p=0.019), such that the relationship between collaboration & shared leadership and social responsibility reputation was more pronounced in communities with high collective efficacy.

Conclusion

By actively engaging their communities, rural hospitals can improve their reputation regarding the quality of services and their social responsibility.