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Institutional and economic determinants of public health system performance

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  • Mays, G.P.
  • McHugh, M.C.
  • Shim, K.
  • Perry, N.
  • Lenaway, D.
  • Halverson, P.K.
  • Moonesinghe, R.

Abstract

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.

Suggested Citation

  • Mays, G.P. & McHugh, M.C. & Shim, K. & Perry, N. & Lenaway, D. & Halverson, P.K. & Moonesinghe, R., 2006. "Institutional and economic determinants of public health system performance," American Journal of Public Health, American Public Health Association, vol. 96(3), pages 523-531.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2005.064253_1
    DOI: 10.2105/AJPH.2005.064253
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    Cited by:

    1. Yonsu Kim & Jae Hong Kim, 2022. "What drives variations in public health and social services expenditures? the association between political fragmentation and local expenditure patterns," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 781-789, July.
    2. Miaomiao Tian & Da Feng & Xi Chen & Yingchun Chen & Xi Sun & Yuanxi Xiang & Fang Yuan & Zhanchun Feng, 2013. "China's Rural Public Health System Performance: A Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-10, December.
    3. Abanoub Riad & Nuraldeen Maher Al-Khanati & Julien Issa & Mazen Zenati & Nèziha Ben Abdesslem & Sameh Attia & Martin Krsek, 2022. "Oral Health-Related Knowledge, Attitudes and Behaviours of Arab Dental Students: Multi-National Cross-Sectional Study and Literature Analysis 2000–2020," IJERPH, MDPI, vol. 19(3), pages 1-21, January.
    4. Jambroes, Marielle & Lamkaddem, Majda & Stronks, Karien & Essink-Bot, Marie-Louise, 2015. "Enumerating the preventive youth health care workforce: Size, composition and regional variation in the Netherlands," Health Policy, Elsevier, vol. 119(12), pages 1557-1564.
    5. Kankana Mukherjee & Rexford Santerre & Ning Jackie Zhang, 2010. "Explaining the efficiency of local health departments in the U.S.: an exploratory analysis," Health Care Management Science, Springer, vol. 13(4), pages 378-387, December.
    6. Cinzia Di Novi & Dino Rizzi & Michele Zanette, 2018. "Scale Effects and Expected Savings from Consolidation Policies of Italian Local Healthcare Authorities," Applied Health Economics and Health Policy, Springer, vol. 16(1), pages 107-122, February.
    7. Betty Bekemeier & David Grembowski & Youngran Yang & Jerald R. Herting, 2014. "Are Local Public Health Department Services Related to Racial Disparities in Mortality?," SAGE Open, , vol. 4(1), pages 21582440145, March.

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