Standardizing measurement to better study variation in local public health services: Minnesota's MPROVE Experience

The Multi-network Practice and Outcome Variation Examination (MPROVE), is a multi-state study aimed at studying the variation in public health services among local jurisdictions. Minnesota provided guidance to measure selection and the relevant data for 30 measures that cover chronic disease, communicable disease and environmental health.  In Minnesota, the practice-based research network (PBRN) is housed at the state health department.  This enabled the Minnesota PBRN to obtain most of the communicable disease and environmental health measures in-house. The chronic disease measures were incorporated into an online, annual reporting system for local public health, by making use of existing relationships and mechanisms.  

Overall, the MPROVE package of measures highlight the complexity of how Minnesota delivers public health services at the local level. Relatively little variation was detected on many measures. Statewide funding for policy, systems and environmental (PSE) change strategies has likely contributed to fairly widespread, population-based approaches to tobacco and obesity prevention. In addition, the state-local partnership to address communicable disease and environmental health may have resulted in more standard service levels across the state.

Minnesota-specific analyses also examined variation in MPROVE chronic disease services by level of QI maturity and capacity, as measured by local public health’s ability to meet national standards. Preliminary analysis suggests some variation among Minnesota CHBs in the provision of several specific services by levels of organizational QI maturity and capacity, however variation was not seen for all of the measures within the chronic disease domain.