Relationships among providing maternal, child, and adolescent health services; Implementing various financial strategy responses; And performance of local health departments

L.M. Issel, C. Olorunsaiye, L. Snebold and A. Handler

American Journal of Public Health, 2015, vol. 105, S244-S251

Abstract: Objectives: We explored the relationships between local health department (LHD) structure, capacity, and macro-context variables and performance of essential public health services (EPHS). Methods: In 2012, we assessed a stratified, random sample of 195 LHDs that provided data via an online survey regarding performance of EPHS, the services provided or contracted out, the financial strategies used in response to budgetary pressures, and the extent of collaborations.We performed weighted analyses that included analysis of variance, pairwise correlations by jurisdiction population size, and linear regressions. Results: On average, LHDs provided approximately 13 (36%) of 35 possible services either directly or by contract. Rather than cut services or externally consolidating, LHDs took steps to generate more revenue and maximize capacity. Higher LHD performance of EPHS was significantly associated with delivering more services, initiating more financial strategies, and engaging in collaboration, after adjusting for the effects of the Affordable Care Act and jurisdiction size. Conclusions: During changing economic and health care environments, we found that strong structural capacity enhanced local health department EPHS performance for maternal, child, and adolescent health.

Keywords: adolescent; child; child health care; cooperation; government; health care delivery; health care policy; health service; human; organization and management; public health service; statistics and numerical data; system analysis; United States, Adolescent; Adolescent Health Services; Child; Child Health Services; Cooperative Behavior; Health Services Accessibility; Humans; Local Government; Maternal Health Services; Patient Protection and Affordable Care Act; Public Health Administration; Systems Analysis; United States (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302288_2

DOI: 10.2105/AJPH.2014.302288

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