Institutional and Economic Determinants of Public Health System Performance

Datos Bibliográficos

ID11022613
AutoresGlen P Mays (0000-0002-7837-6812, At the time of the study, Glen P. Mays and Megan C. McHugh were with Mathematica Policy Research in Washington, DC, and Kyumin Shim, Natalie Perry, Dennis Lenaway, Paul Halverson, and Ramal Moonesinghe were with the Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Ga.), Megan Mchugh (0000-0001-8101-3441, The Centers), Megan C McHugh (At the time of the study, Glen P. Mays and Megan C. McHugh were with Mathematica Policy Research in Washington, DC, and Kyumin Shim, Natalie Perry, Dennis Lenaway, Paul Halverson, and Ramal Moonesinghe were with the Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Ga.), Kyumin Shim (At the time of the study, Glen P. Mays and Megan C. McHugh were with Mathematica Policy Research in Washington, DC, and Kyumin Shim, Natalie Perry, Dennis Lenaway, Paul Halverson, and Ramal Moonesinghe were with the Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Ga.), Natalie Perry (At the time of the study, Glen P. Mays and Megan C. McHugh were with Mathematica Policy Research in Washington, DC, and Kyumin Shim, Natalie Perry, Dennis Lenaway, Paul Halverson, and Ramal Moonesinghe were with the Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Ga.), Dennis Lenaway (At the time of the study, Glen P. Mays and Megan C. McHugh were with Mathematica Policy Research in Washington, DC, and Kyumin Shim, Natalie Perry, Dennis Lenaway, Paul Halverson, and Ramal Moonesinghe were with the Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Ga.), Paul K Halverson (0000-0001-7684-4363, At the time of the study, Glen P. Mays and Megan C. McHugh were with Mathematica Policy Research in Washington, DC, and Kyumin Shim, Natalie Perry, Dennis Lenaway, Paul Halverson, and Ramal Moonesinghe were with the Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Ga.), Ramal Moonesinghe (0000-0001-5327-533X, At the time of the study, Glen P. Mays and Megan C. McHugh were with Mathematica Policy Research in Washington, DC, and Kyumin Shim, Natalie Perry, Dennis Lenaway, Paul Halverson, and Ramal Moonesinghe were with the Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Ga.)
Año2006
Volumen96
Número3
Páginas523-531
Fecha de publicación2006-03-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaAmerican Journal of Public Health (JOURNAL)
Identificadores de la revistaISSN: 0090-0036 • E-ISSN: 1541-0048
EditorialAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2005.064253
PMID16449584
PMCIDPMC1470518
OpenAlexW2039597377
IdiomaEN
Citas recibidas31
Referencias citadas24

Objectives. Although a growing body of evidence demonstrates that availability and quality of essential public health services vary widely across communities, relatively little is known about the factors that give rise to these variations. We examined the association of institutional, financial, and community characteristics of local public health delivery systems and the performance of essential services. Methods. Performance measures were collected from local public health systems in 7 states and combined with secondary data sources. Multivariate, linear, and nonlinear regression models were used to estimate associations between system characteristics and the performance of essential services. Results. Performance varied significantly with the size, financial resources, and organizational structure of local public health systems, with some public health services appearing more sensitive to these characteristics than others. Staffing levels and community characteristics also appeared to be related to the performance of selected services. Conclusions. Reconfiguring the organization and financing of public health systems in some communities—such as through consolidation and enhanced intergovernmental coordination—may hold promise for improving the performance of essential services

Business · Consolidation (business) · Economics · Environmental health · Public economics · Public health · Staffing · Accounting · Community Health and Development · Healthcare Policy and Management · Medicine · Nursing · Public Health Policies and Education