Document Type

Presentation

Presentation Date

4-2015

Abstract or Description

Background: Recent work has highlighted the necessity of integrating primary care services and public health to improve quality and reduce the cost of healthcare.

Research Objectives: To describe levels of partnership between local health departments (LHD) and other organizations in the community in the provision of personal healthcare services; and to assess LHD organizational characteristics and community factors that contribute to partnerships.

Data Sets and Sources: Data were drawn from the 2013 NACCHO Profile Study (Module 1) and the Area Health Resource File. A total of 490 LHDs responded to Module 1, where LHDs were asked to describe the level of partnership for selected programs including three personal healthcare services—Maternal and Child Health (MCH), communicable/infectious disease control, and chronic disease prevention. The five levels of partnership were measured on an ordinal level from “not involved”, “networking”, “coordinating”, “cooperating”, to “collaborating”, with “collaborating” as the highest level of partnership. The level of partnership in these three personal healthcare services were the outcomes examined in this analysis. Covariates included both LHD organizational and community factors.

Study Design: This is a cross-sectional study, based on secondary data from multiple sources, linked at the LHD as a unit of observation.

Analysis: Three ordinal logistic regression models were run to assess factors associated with higher levels of partnership in the three personal healthcare programs. Data analyses were conducted using Stata 13 SVY procedures to account for the Profile Study’s survey design.

Principal Findings:Overall, proportions of LHDs at the five levels of partnership—not involved, networking, coordinating, cooperating , and collaborating—for MCH were 11.8%, 12.4%, 28.3%, 24.9%, and 22.6%; for infectious disease control were 8.1%, 3.9%, 27.6%, 31.8%, and 28.9%; for chronic disease prevention were 10.4%, 14.2%, 37.7%, 21.2%, and 16.5%, respectively The proportion of LHDs engaged in collaboration, the highest level of partnership, increased with LHD jurisdiction population size. For MCH, 14.1% of LHDs with =500,000 people reported collaboration (p=500,000 reported collaboration with other organizations in the community (p

Conclusion: Level of partnership varied across LHDs of different jurisdiction population sizes. And the level of partnership was highest for infectious disease control, and the lowest in chronic disease prevention.

Implications for Public Health Practice and Policy: Factors that might promote LHD’s collaboration in the provision of personal health care services include having a public health physician on staff, higher per capita expenditure, and conducting a community health assessment.

Additional Information

Reproduced with permission of the National Coordinating Center for PHSSR and the Robert Wood Johnson Foundation, Princeton, N.J. Presentation obtained from the Keeneland Conference site.

Sponsorship/Conference/Institution

Keeneland Conference for Public Health Systems and Services Research

Location

Lexington, KY

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