Investigating the impact of partnerships on revenue generating strategies of local public health departments

RESEARCH OBJECTIVES: Partnerships can improve local health departments' (LHD) opportunities to generate additional revenues. By partnering with federal, state and nongovernmental organization LHDs can increase their chances of getting grants. LHDs can also expand their clientele base by partnering with insurance companies, hospitals, doctors.

STUDY DESIGN: Our goal is to investigate if there is statistical association between revenues of LHDs and their partnership relationships with the following 12 partners: federal, state government, universities, community heath centers, hospitals, providers, insurance companies, non-profits, professional associations, community organizations, businesses, and faith-based organizations. We use quantile regression to estimate revenue function that relates outcome variable (LHD revenues per person served in the jurisdiction) to number of public health services provided by LHD in a jurisdiction, number of LHD employees and a set of 12 dichotomous partnership variables.

POPULATION STUDIED: The main source of data on LHD revenues and partnerships is the 1996 NACCHO survey of LHDs. The sample size is N=1680.

PRINCIPAL FINDINGS: LHDs that established partnerships with community heath centers tend to have higher revenues than the ones that do not. Partnerships with federal government and non-profits have statistically significant association with revenues at the lower revenue quantiles, while partnerships with insurance companies and universities - at the upper and mid range of revenue distribution. No statistically significant correlation between LHD revenues and partnerships with hospitals, doctors, businesses and faith-based organizations was discovered.

CONCLUSIONS: Different types of partnerships influence ability of a LHD to generate more revenues in a distinctive way. Partnerships with community health centers, federal government, universities, insurance companies, non-profit organizations tend to be associated with higher revenues. Our model does not provide evidence of positive impact of LHD partnerships with hospitals, doctors, businesses and faith-based organizations, state government, professional and community organizations on LHD revenues at any quantile.