264140 Estimating Gains from Regional Delivery of Public Health Services

Monday, October 29, 2012 : 11:30 AM - 11:50 AM

Glen Mays, PhD, MPH , College of Public Health, University of Kentucky, Lexington, KY
Richard Ingram, DrPH , College of Public Health, University of Kentucky, Lexington, KY
Rachel Hogg, MA , National Coordinating Center for Public Health Systems and Services Research, University of Kentucky-College of Public Health, Lexington, KY
Kristina Rabarison, MS , National Coordinating Center for Public Health Services and Systems Research, University of Kentucky - College of Public Health, Lexington, KY
     
OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health.

METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the availability of 20 core public health services within their jurisdictions, the organizations that deliver each, and the perceived effectiveness of services. Hierarchical regression was used to simulate the effects of regional service delivery models that pool resources across neighboring public health agency jurisdictions that fall below selected population thresholds.

RESULTS: The scope of public health services delivered in the average U.S. community increased from 64% to 71% during the 14 year period (p<0.05), and increased significantly with the agency's scale of operations (population size served, p<0.001). Simulation results predicted that combining neighboring public health agency jurisdictions serving less than 50,000 residents would produce a 26% increase in the scope of services delivered, a 19% increase in perceived effectiveness, and statistically significant reductions in selected measures of preventable mortality.

CONCLUSIONS: Regional strategies to coordinate and/or consolidate the operations of small and rural public health agencies may improve public health delivery and population health.

Learning Areas:
Administration, management, leadership
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Identify regional strategies to coordinate and/or consolidate the operations of small and rural public health agencies. Discuss longitudinal observations on a national sample of local public health agencies to estimate the effects of regional delivery models on the availability and effectiveness of public health services.

Keywords: Partnerships, Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently a public health doctoral student at the University of Kentucky College of Public Health acting as a research assistant in the National Coordinating Center for Public Health Systems and Services Research. Specifically, I have been a research assistant involved in the Public Health Practice-Based Research Networks since August of 2011.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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