The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60245

F. Douglas Scutchfield, MD¹, Evelyn Knight, PhD², Ann V. Kelly, MHA², Michelyn W. Bhandari, MPH², and Ilie Puiu Vasilescu, PhD³. (1) Center for Health Services Management and Research, University of Kentucky School of Public Health, Rm 102, 121 Washington Avenue, Lexington, KY 40536-0003, 859-257-6504, scutch@uky.edu, (2) Center for Health Services Management and Research, University of Kentucky, 121 Washington Avenue, Rm 109, Lexington, KY 40536-0003, (3) Visiting Professor, University of Virginia's College at Wise, Department of Social and Behavioral Sciences, Titu Maiorescu University at Bucharest, First College Ave., 237 Smiddy Hall, Wise, VA 24293-4412

Improving performance and capabilities of local public health systems (LPHS) has become a national concern, and identifying factors associated with high performing health systems is a research priority. This study explores the extent to which performance on the 10 Essential Public Health Services (EPHS) explains higher levels of public health services provided (outputs), based on the structural resources (capacity) of the agency. LPHS performance assessment results from three states that participated in the National Public Health Performance Standards Program test during 2000 were matched at the county level to data on three groups of services and structural capacity variables from the 1996 National Association of City and County Health Officials profile of local health departments, yielding 152 cases. Results show that capacity indicators are related to levels of service delivery. However, when controlling for EPHS, this relationship becomes non-significant for certain variables, indicating that performance on the EPHS plays a role in translating capacity into outputs. For example, the relationship between health department partnerships and the delivery of a group of basic services is explained by high performance scores on EPHS#3, education and empowerment, and ESPH #5, policy development and planning. Also, performance on each of the 10 EPHS explains the translation of per capita health department expenditures into basic services. These findings and others to be presented suggest that the EPHS performance results can significantly contribute to the understanding of infrastructure and productivity of health departments. Further study will enhance the science base for improving public health system performance.

Learning Objectives:

Following this presentation, the participant will be able to:
• Describe the importance of LPHS performance in translating health department capacity into services (outputs).
• Identify capacities that contribute to higher performance on Essential Public Health Services.
• Identify areas for further investigation regarding inputs to higher performance on the EPHS and higher levels of services provided by local health departments.

Keywords: Performance Measurement, Public Health Research

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: National Public Health Performance Standards Program (CDC)
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.