Workforce Education and Experience as a Factor in Disease Case Investigation Efficiency

Background

Public health infrastructure is a fundamental aspect in effectively executing public health services, and a key component of the public health infrastructure is a capable and qualified workforce. Data is limited however in showing the impact of a qualified workforce on public health service delivery and cost. The Colorado Public Health Practice-Based Research Network calculated the cost of communicable disease (CD) surveillance for LPHAs in Colorado. We found substantial variation in the time and cost per case across the state. This analysis seeks to evaluate the impact of workforce experience and education on this variation.

Data Sets and Sources

Data used was collected as part of the Colorado DACS study. Colorado local public health employees engaged in CD work logged their time spent on CD surveillance for a two-week period. Forty-three of the 54 LPHAs in Colorado participated in the data collection. The 97 respondents also provided personal information including their educational background and years of experience in CD. This primary data was supplemented with data from the Colorado Electronic Disease Reporting System related to the duration of case investigation and the case mix during primary data collection. Descriptive statistics, including correlation coefficients and two-sample T tests, were calculated to understand how years of experience and educational attainment impacted the cost per case and time per case needed for CD surveillance investigation. Additionally, logistic regression will be used to determine which factors affect an agency’s ability to close an investigation followed by a second regression analysis to determine influential factors that affect the length of case investigation.

Principal Findings

After calculating descriptive statistics, no correlation was found between years of experience and time spent per case investigation or cost per case investigation. When evaluating the impact of education on time and cost per case, neither differed significantly between agencies that did and did not have an employee with a graduate degree. However, time and cost per case did differ significantly for agencies that did and did not have an employee with a public health-specific degree and between agencies that did and did not have a staff member completely dedicated to CD work

Conclusions

Hiring a public health trained employee, as well as having a staff member dedicated to CD, may improve case investigation efficiency.