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Integration of Health and Social Services at the Systems Level

A Framework for Addressing Funding and Jurisdictional Silos

Bibliographic Data

ID11029099
AuthorsJ Mac McCullough (0000-0002-0070-4943, J. Mac McCullough and Megan A. Phillips are with the College of Health Solutions, Arizona State University, Phoenix. Jonathon P. Leider is with the Division of Health Policy & Management, University of Minnesota School of Public Health, Minneapolis.), Jonathon P Leider (0000-0001-9905-476X, J. Mac McCullough and Megan A. Phillips are with the College of Health Solutions, Arizona State University, Phoenix. Jonathon P. Leider is with the Division of Health Policy & Management, University of Minnesota School of Public Health, Minneapolis.), Megan Phillips (0000-0001-9713-4344, Department of Public Health), Megan A Phillips (J. Mac McCullough and Megan A. Phillips are with the College of Health Solutions, Arizona State University, Phoenix. Jonathon P. Leider is with the Division of Health Policy & Management, University of Minnesota School of Public Health, Minneapolis.)
Year2020
Volume110
IssueS2
PagesS197-S203
Publication date2020-07-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2020.305735
PMID32663082
OpenAlexW3043117498
LanguageEN
Citations received3
References cited19

Objectives. To examine spending and resource allocation decision-making to address health and social service integration challenges within and between governments. Methods. We performed a mixed methods case study to examine the integration of health and social services in a large US metropolitan area, including a city and a county government. Analyses incorporated annual budget data from the city and the county from 2009 to 2018 and semistructured interviews with 41 key leaders, including directors, deputies, or finance officers from all health care–, health-, or social service–oriented city and county agencies; lead budget and finance managers; and city and county executive offices. Results. Participants viewed public health and social services as qualitatively important, although together these constituted only $157 or $1250 total per capita spending in 2018, and per capita public health spending has declined since 2009. Funding streams can be siloed and budget approaches can facilitate or impede service integration. Conclusions. Health and social services should be integrated through greater attention to the budgetary, jurisdictional, and programmatic realities of health and social service agencies and to the budget models used for driving the systems-level pursuit of population health

Business · Economic growth · Economics · Environmental health · Government (linguistics) · Health care · Metropolitan area · Per capita · Population · Population health · Public health · Social determinants of health · Finance · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes · Public Health Policies and Education · Health Policy · Social Work

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Unique citing works3
Citations per year0,6
Citation span2021 - 2024 (4)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 2
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