The Role of Interorganizational Partnerships in Health Services Provision Among Rural, Suburban, and Urban Local Health Departments
The Role of Interorganizational Partnerships in Health Services Provision Among Rural, Suburban, and Urban Local Health Departments
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DOI：
10.1111/j.1748-0361.2010.00285.x
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发表时间：
2010-06-01
影响因子：
4.9
通讯作者：
Barnes, Priscilla A.
中科院分区：
文献类型：
--
作者：
Beatty, Kate;Harris, Jenine K.;Barnes, Priscilla A.
背景：由于资源有限和美国面临的公共卫生挑战日益增加，美国疾病控制与预防中心（Centers for Disease Control and Prevention）和其他机构已经确定，地方卫生部门（lhd）和非政府组织（ngo）之间的合作关系对公共卫生系统至关重要。lhd利用财政、人力和信息资源，并与当地非政府组织建立伙伴关系，提供公共卫生服务。目的：本研究有两个主要目标：(1)比较农村、郊区和城市LHD的资源和伙伴关系特征；(2)确定伙伴关系是否在LHD资源和LHD提供的服务之间起中介作用。方法：我们利用2005年全国县和市卫生官员协会概况研究进行二次数据分析。我们使用卡方和方差分析（ANOVA）来检验农村、郊区和城市lhd之间的差异。我们使用基于回归的中介方法来检验伙伴关系是否中介了资源和服务提供之间的关系。结果：我们发现lhd之间存在显著差异。与郊区或农村的基层医疗机构相比，城市基层医疗机构的服务范围更广，预算更多，员工更多，与当地非政府组织建立了更多的伙伴关系，并提供了更多的医疗服务。我们发现伙伴关系是资源和服务提供之间的部分中介。通过发挥中介作用，伙伴关系减少了农村、郊区和城市低卫生保健机构在服务提供方面的差异。结论：伙伴关系在低卫生保健机构资源与服务提供之间起中介作用。地方卫生部门可以更加重视与当地非政府组织的关系，以增加服务的提供。这一战略可能对面临有限资源和众多健康差距的农村低收入者特别有用。
Context: With limited resources and increased public health challenges facing the US, the Centers for Disease Control and Prevention and others have identified partnerships between local health departments (LHDs) and nongovernmental organizations (NGOs) as critical to the public health system. LHDs utilize financial, human, and informational resources and develop partnerships with local NGOs to provide public health services.Purpose: Our study had 2 primary goals: (1) compare resources and partnerships characterizing rural, suburban, and urban LHDs, and (2) determine whether partnerships play a mediating role between LHD resources and the services LHDs provide.Methods: We conducted secondary data analysis using the National Association of County and City Health Officials 2005 Profile Study. We used chi-squared and analysis of variance (ANOVA) to examine differences between rural, suburban, and urban LHDs. We used regression-based mediation methods to test whether partnerships mediated the relationship between resources and service provision.Findings: We found significant differences between LHDs. Urban LHDs serve larger jurisdictions, have larger budgets and more staff, cultivate more partnerships with local NGOs, and provide more health services than suburban or rural LHDs. We found that partnerships were a partial mediator between resources and service provision. In playing a mediating role, partnerships reduce differences in service provision between rural, suburban, and urban LHDs.Conclusions: Partnerships mediate the relationship between resources and service provision in LHDs. LHDs could place more emphasis on cultivating relationships with local NGOs in order to increase service provision. This strategy may be especially useful for rural LHDs facing limited resources and numerous health disparities.