Document Detail

Governance typology: a consensus classification of state-local health department relationships.
MedLine Citation:
PMID:  23023276     Owner:  NLM     Status:  In-Data-Review    
CONTEXT: : Public health practitioners and researchers often refer to state public health systems as being centralized, decentralized, shared, or mixed. These categories refer to governance of the local public health units within the state and whether they operate under the authority of the state government, local government, shared state and local governance, or a mix of governance structures within the state.
OBJECTIVE: : This article describes the development of an objective method of classifying states as centralized, decentralized, shared, or mixed. We also discuss some initial analyses that have been conducted to identify how public health resources and activities vary across states with different classifications.
DESIGN: : Cross-sectional study.
SETTING: : State health agencies.
PARTICIPANTS: : Survey respondents were organizational leaders from all 50 state health agencies.
MAIN OUTCOME MEASURE(S): : Total full-time equivalent employees, total health agency expenditures, expenditures on clinical services, and provision of clinical services.
RESULTS: : Centralized state health agencies employ more full-time equivalent employees, have higher total expenditures, and provide more clinical services than decentralized state health agencies. Although higher expenditures on clinical services were observed, these differences were not statistically significant.
CONCLUSIONS: : It is important to take governance classification into account when investigating variation in services, resources, or performance of governmental public health systems. As public health systems and services researchers seek to identify best practices in the organization of public health systems, consistent definition of different types of organization is critical. This system provides an objective and reliable system for classifying governance relationships that allows for comparisons that are meaningful to both practitioners and researchers.
Michael Meit; Katie Sellers; Jessica Kronstadt; Nikki Lawhorn; Alexa Brown; Rivka Liss-Levinson; Jim Pearsol; Paul E Jarris
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of public health management and practice : JPHMP     Volume:  18     ISSN:  1550-5022     ISO Abbreviation:  J Public Health Manag Pract     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505213     Medline TA:  J Public Health Manag Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  520-8     Citation Subset:  T    
NORC at the University of Chicago, Bethesda, Maryland (Mr Meit, Ms Kronstadt, and Ms Brown); Association of State and Territorial Health Officials (ASTHO), Arlington, Virginia (Drs Sellers, Liss-Levinson, and Jarris, and Mr Pearsol); and National Network of Public Health Institutes, New Orleans, Louisiana (Dr Lawhorn).
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