Public Health Activities and Tracking (PHAST) Study: Putting local health department service statistics to use in measuring system-wide outputs

Background: The Public Health Activities and Tracking (PHAST) Study is working through the 12 state-wide Public Health Practice-based Research Networks (PBRN) to establish a mechanism for examining health outcomes associated with variation and change in local health department (LHD) service delivery. Retrospective LHD services data from PBRN states are being used to develop an initial minimum dataset of comparable data. Methodology: Secondary longitudinal data (when available) depicting services provided annually by LHDs from 2005-2010 have been compiled from state-level sources and included into a single analytical file. Assessing data generation processes for data comparability has involved examining data documentation and working with PHAST study partners to assess data quality and comparability. Results: Findings indicate that PHAST states do tend to maintain some annual LHD service output data and that data are often accessible and occasionally comparable across PBRN states. Budget cuts, inconsistent data quality, and a lack of data definition documentation are factors in the utility and accessibility of some data. Issues such as the financial crisis and accreditation efforts, however, have increased interest in accountability regarding LHD services and have generated interest in improving the quality of LHD service data. The investment of and the local knowledge and relationships maintained by PBRN partners regarding the nature of their data has been critical to this process. Conclusions: Detailed LHD service output data can be accessed through state-level channels via PBRN partners with strong local knowledge, suggesting promise for the success of PHAST, prospective data collection, and ongoing tracking of services.