Online Program

Assessing key informant perceptions and the effects of an 18-year fully integrated medicine and public health partnership: The experience of Charlotte, Mecklenburg County, North Carolina

Monday, November 2, 2015 : 3:30 p.m. - 3:45 p.m.

Crystal Piper, MPH, MHA, PhD, Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC
Marcus Plescia, MD MPH, Public Health, Mecklenburg County, Charlotte, NC
Mark J. DeHaven, PhD, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC
Stephen Keener, MD, MPH, FACPM, Mecklenburg County Health Department, Charlotte, NC
Background: Numerous forces – notably health care reform - have renewed interest in clinical medicine and public health collaboration.  Although promising practices have been proposed, few functionally integrated programs exist.  We describe and assess the effectiveness of an 18-year contractual partnership (1995 – 2013) in Mecklenburg County, NC, between the community’s largest health care system and local health department. Methods:  In-depth key-informant interviews and impact assessments (January – February 2015), of leaders (N=20; 10 public health and 10 health care) who participated in partnership design and/or implementation.  Study design is adapted from N Y Academy of Medicine, Committee on Medicine and Public Health.  Data were analyzed using classic content analysis and Likert Scales for assessing impact. Results: The partnership was designed to improve service delivery and overall public health system efficiency; the health care system assumed management of public health staff and services (e.g. clinical, health promotion, nutrition, case management and epidemiology).  We assessed impact in six areas: 1) coordinating services; 2) increasing access; 3) improving quality; 4) improving community health; 5) mobilizing community campaigns; and, 6) shaping future directions.  The areas of greatest impact were coordinating services (3.5, 5=great impact) and improving access to care (3.3); least impactful addressing community health problems (2.9).  The partnership was perceived as relatively ineffective in addressing the underlying causes of disease, framing health care policy, or developing cross-sector training. Conclusions:We discuss the implications for public health departments of combining corporate medicine and public health in an era of health care reform.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Provision of health care to the public

Learning Objectives:
Describe the unique features and components of a large health care system and public health department partnership in a large Southern city in the United States. Assess the strengths, weaknesses, achievements, and challenges of health care system and public health partnership, based on the views of key informant leaders involved in designing and implementing the partnership.

Keyword(s): Health Systems Transformation, Partnerships

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author, because I served as a primary investigator and was involved in the design and implementation of the project. I have served as a co-principal investigator on similar projects in the past.
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.