Online Program

Variation in local health departments' cost of providing clinical health services: Evidence from Florida

Tuesday, November 5, 2013 : 11:10 a.m. - 11:30 a.m.

Simone Singh, Ph.D., Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI
While overall spending patterns of local health departments (LHDs) have been studied extensively, little is known about how efficiently LHDs use their financial resources. This study documents the substantial variation in LHDs' cost of service provision and analyzes how LHD organizational and community characteristics contribute to these variations.

Data for this study was obtained from the Florida Department of Health. Financial data for the period from 2001 to 2011 for all 67 LHDs in Florida was supplemented with data on LHD organizational and community characteristics from NACCHO's Profile Studies and the Area Resource File. Descriptive analysis was used to examine the costs of clinical health services provided by LHDs and to evaluate trends. Bivariate analysis of variations in costs was conducted along select LHD organizational and community characteristics, including size of population served, location, volume and mix of services, and staffing patterns. Services analyzed included select clinical health services provided by LHDs, such as comprehensive child and adult health services and dental health services.

Descriptive analysis found that the costs of clinical health services provided by LHDs varied substantially both across service lines and over time. Few LHDs have consistently low costs for all the clinical health services they provide. Bivariate analysis showed that low-cost LHDs differed substantially from high-cost LHDs. Most notably, low-cost LHDs provided higher volumes of a given service and used their staff more productively. Economies of scale and staff productivity thus appear to be key to LHDs' ability to provide clinical health services in an efficient manner.

In times of budget shortfalls and reduced funding for public health activities, an in-depth understanding of LHDs' costs of service provision can help local health officers provide essential services at a lower cost and allocate resources to those areas where they have the biggest impact on population health.

Learning Areas:

Administration, management, leadership
Public health administration or related administration

Learning Objectives:
Describe the variation in local health departments' costs of providing select clinical health services using evidence from the state of Florida Compare high- and low-cost local health departments in Florida along a set of select LHD organizational and community characteristics

Keyword(s): Cost Issues, Public Health Administration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a PhD in health services organization and policy with a focus on accounting and finance. I have 8 years of research experience and have conducted numerous research studies in the areas of healthcare and public health financing. Among my research interests is the study of the financial management of public health organizations focusing specifically on local health departments' cost structure, productivity, and efficiency of service provision.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.