Examining the Financing of Primary Care Services in Public Health Departments

This study is a retrospective, longitudinal population-based analysis to examine the cost of privatized primary care programs versus the cost of primary care programs provided within county health departments in Florida. Economic theorists promote contracting-out services as a means of increasing efficiency and lowering cost while at the same time improving access to services and health outcomes. The purpose of this study is to determine if private providers can provide primary care services more efficiently to an underserved population.

Secondary data sources were obtained from the Florida Department of Health. The programs included in this study are clinically based programs and include family planning, maternal health, healthy start prenatal and infants, and comprehensive child and adult health. The data were analyzed using a mixed model repeated measures design. Using cost as a dependent variable, the purpose of the analysis was to determine if there was a difference in cost between privatized programs and non-privatized programs. A second analysis was conducted to determine if there was a difference among the privatized programs versus the non-privatized programs with regard to the number of clients and services, or expenditures per client and service.

The results of analyses revealed that there was no significant difference between the privatized and non-privatized programs on cost, number of clients served, or services provided. The significance of this study is that it uses multiple years of actual data to examine whether private providers can reduce the costs of providing primary care in a low income population.