Exploring the relationship between organizational equity orientation and community orientation: A comprehensive analysis of the U.S. hospital landscape.

Background: Community orientation, developed and fostered through partnerships between hospitals and community organizations, is a key approach for health care organizations to build deeper community ties. Such efforts are instrumental in building trust within the community, and one way for hospitals to do so is to develop a strong organizational equity orientation as a strategic priority.

Purpose: The aim of the study was to explore the association between hospitals' organizational equity and community orientation using Moulton's publicness theory framework, which focuses on cultural-cognitive, regulative, and normative public value.

Methodology/approach: Using data from 2021 to 2022 American Hospital Association annual surveys and the 2018 Social Capital Project, a Poisson model with random effects was conducted to assess the association between hospitals' internal equity orientation and community orientation.

Results: Hospitals with higher organizational equity orientation were associated with an increased degree of community orientation (incident rate ratio [IRR] = 1.04, p < .001). Not-for-profit and public hospital ownership (IRR = 1.66 and 1.53, p < .001, respectively), teaching status (IRR = 1.08, p < .001), The Joint Commission accreditation (IRR = 1.07, p < .001), and higher social capital (IRR = 1.10, p < .05) were also associated with higher degree of community orientation.

Conclusions: As hospitals explore opportunities to reduce disparities and improve equity, they should focus on measuring and assessing organizational equity orientation at various levels, which can, in turn, offer an advantage in deepening community relationships.

Practice implications: With increasing emphasis from Centers for Medicare & Medicaid Services on health equity and community partnerships, hospitals prioritizing organizational equity in multiple ways may stand to benefit. By demonstrating a commitment to equity within the organizations, hospitals will be more likely to gain trust from community partners.