Padgett Stephen M, Kinabrew Christopher, Kimbrell Joseph, Nicola Ray M
Turning Point National Program Office, University of Washington, Seattle, WA 98109, USA.
J Public Health Manag Pract. 2005 Mar-Apr;11(2):116-22. doi: 10.1097/00124784-200503000-00004.
Public Health Institutes are free-standing multisector entities able to function as conveners to improve health status and foster innovations in health systems. Turning Point is a program funded by The Robert Wood Johnson Foundation, involving 21 statewide initiatives and 2 "linked" states that formed multisector collaborative partnerships for public health systems change. In 18 of the Turning Point states, there are also Public Health Institutes, some formed by Turning Point partnerships and some established independently. Both Turning Point and Public Health Institutes represent efforts to reform and enhance public health systems. What has been the relationship between these two organizational forms? This descriptive, qualitative study examined the relationships between state-level Turning Point partnerships and Public Health Institutes in states that have both. Key participants in both institutions were interviewed, and models were developed to represent those relationships. Principal findings suggest that the relationships of Turning Point state partnerships with Public Health Institutes have taken many shapes. Factors that influence the choices and sequencing of these options are largely related to the political and economic resources of each state. Turning Point participants perceived Public Health Institutes to be a useful organizational form for sustaining public health systems change. Public Health Institutes have more administrative and fiscal flexibility than state government and greater opportunities for policy development and advocacy. However, free-standing institutes also have greater financial uncertainty.
公共卫生研究所是独立的多部门实体，能够作为召集者，以改善健康状况并促进卫生系统的创新。转折点项目由罗伯特·伍德·约翰逊基金会资助，涉及21个州级倡议以及2个“联动”州，这些州为公共卫生系统变革形成了多部门合作关系。在转折点项目涉及的18个州中，也有公共卫生研究所，其中一些是由转折点项目的合作关系组建而成，一些则是独立设立的。转折点项目和公共卫生研究所都代表了对公共卫生系统进行改革和加强的努力。这两种组织形式之间的关系是怎样的呢？这项描述性的定性研究考察了同时拥有这两者的州中，州级转折点项目合作关系与公共卫生研究所之间的关系。对这两个机构的关键参与者进行了访谈，并构建了模型来呈现这些关系。主要研究结果表明，转折点项目州级合作关系与公共卫生研究所之间的关系呈现出多种形式。影响这些选择及其先后顺序的因素在很大程度上与每个州的政治和经济资源有关。转折点项目的参与者认为公共卫生研究所是维持公共卫生系统变革的一种有用的组织形式。公共卫生研究所比州政府拥有更多的行政和财政灵活性，以及更多的政策制定和宣传机会。然而，独立的研究所也面临更大的财务不确定性。
