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Community hospital-based clinical research: a vehicle for increasing health equity

Pediatric Research (2024)Cite this article

Clinical research programs situated within community hospital (CH) settings are uniquely positioned to offer an array of opportunities to patients, researchers and communities alike. CHs are defined broadly by the American Hospital Association as “all non-federal, short-term general, and other special hospitals”; in the United States (US) 5,157 institutions met this definition in 2023.1 CHs work to serve both acute and non-acute inpatient, urgent care, maternity and surgical needs. The patient population being served by CHs across the nation is necessary to meet and validate research endpoints, but also is invaluable in contributing to and eliciting positive practice change from healthcare providers which in turn aims to elicit positive patient outcomes.

Although CHs play a vital role in patient care, there are few descriptions of the challenges and obstacles of conducting clinical research in this setting.2 Such challenges are markedly different from those confronted by traditional Academic Medical Centers (AMCs) or collaborative research groups.3 Clinical research programs are necessary within CH settings from a patient health equity (HE) standpoint. HE is defined by the United States Centers for Medicare & Medicaid Services as “the attainment of the highest level of health for all people, where everyone has a fair and just opportunity to attain their optimal health regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or other factors that affect access to care and health outcomes.”4 The need for clinical research in CH settings becomes more obvious when we consider that the majority of hospital admissions across the US in 2023 were within CHs.1 Put simply, research innovations or interventions cannot be reserved for AMCs; to achieve equity, the same or similar opportunities need to be offered in CH settings to avoid limiting HE across the US.

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References

  1. American Hospital Association. Fast Facts on U.S. Hospitals. 2023. Accessed September 28, 2023. https://www.aha.org/statistics/fast-facts-us-hospitals#:~:text=Community%20hospitals%20are%20defined%20as,other%20individually%20described%20specialty%20services.

  2. Snihur, A. et al. Fostering clinical research in the community hospital: Opportunities and best practices. Health. Q 23, 30–36, https://doi.org/10.12927/hcq.2020.26277 (2020).

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Authors and Affiliations

  1. South Shore Hospital, Weymouth, MA, USA

    Stephanie Smith & Mark Waltzman

  2. Boston University School of Medicine, Boston, MA, USA

    Stephanie Smith

  3. Boston Children’s Hospital, Boston, MA, USA

    Mark Waltzman

Authors
  1. Stephanie Smith
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  2. Mark Waltzman
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Both M.W., and S.S., conceptualized the ideas presented in this manuscript. S.S., was the lead author on this manuscript and drafted the majority of the content in this manuscript.

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Correspondence to Stephanie Smith.

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Smith, S., Waltzman, M. Community hospital-based clinical research: a vehicle for increasing health equity. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03055-0

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