U.S. nonprofit hospitals and systems raised more than $8.9 billion through philanthropy last year, according to the Association for Healthcare Philanthropy's annual Report on Giving survey. There was no decline in total giving in fiscal 2012 compared with that of 2011 and an increase of more than 7 percent over fundraising revenue in fiscal 2010.

The survey showed that major gifts, corporate and foundation grants, and annual giving were the largest sources of philanthropy, each representing about 20 percent of donated dollars. Amounts raised by special events accounted for 15 percent and 10 percent came from planned giving.

Among the top 25 percent of hospitals in terms of total production, the majority had fundraising expenses of at least $2 million and employed seven or more full-time fundraising staff members. Major gifts and contributions from corporations and foundations made up more than half of all donations.

Among all respondents, contributions were most commonly used to pay for construction and renovation projects (24 percent), patient care (21 percent), capital equipment (13 percent) and general operations (11 percent). At both teaching and children's hospitals, 16 cents per dollar raised went toward medical research, compared with less than six cents in the survey total. On average, 4 percent of donations were spent on charitable care; however, children's (10 percent), tertiary (6 percent) and community hospitals (4 percent) all devoted proportionally more to charitable care.

The effectiveness and efficiency of fundraising efforts have changed little over the year. For every dollar spent, median return on investment was $3.22, two cents less than in 2011. The cost to raise a dollar remained steady, with a median of 31 cents.

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