Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #99627

Kimberley Isett, PhD¹, Kun Huang², and Keith G. Provan, PhD². (1) Department of Health Policy and Management, Columbia University, 600 West 168th Street, 6th FLoor, New York, NY 10032, 212 342-3905, ki2129@columbia.edu, (2) School of Public Administration and Policy, University of Arizona, 1130 East Helen Streer, Suite 405, Tucson, AZ 85721

With the release of the New Freedom Commission's Achieving the Promise report, there has been a renewed call for knowledge about integration and collaboration to combat fragmentation in local service delivery networks. Knowledge pertaining to how system structure impacts the actual delivery of health services will be an important step for understanding how to design publicly funded health service systems that have been devolved to local communities. One important variable that has yet to be assessed is the impact of not-for-profit versus for-profit agency administration of publicly funded health and human services. This paper examines the structural differences between two networks of service delivery for adults with serious mental illness. The two networks operate under the same institutional and legal setting, but one is administered by a non-profit community-based agency, while the other is administered by a national for-profit company. Data pertaining to relationship content and existence were collected from service providers in the networks approximately six months after an at-risk prospective payment system was implemented through a new, regional behavioral health authority. Social network analysis was used to analyze the structure of the relationships among agencies within the service delivery system and between these agencies and the central administrative authority. We found that the network administered by the nonprofit entity generally had high levels of collaboration, while the private, for-profit network administrative unit had a more fragmented system of collaboration.

Learning Objectives:

• understanding collaboration versus fragmentation in health and human services under for-profit versus nonprofit governance structures.

Keywords: Collaboration, Service Delivery

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation