Wetta-Hall Ruth, Berg-Copas Gina M, Ablah Elizabeth, Herrmann Mary Beth, Kang Susan, Orr Shirley, Molgaard Craig
Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Wichita, KS 67214, USA.
J Public Health Manag Pract. 2007 Sep-Oct;13(5):469-75. doi: 10.1097/01.PHH.0000285199.69673.04.
To assess the impact of regionalization of Kansas counties associated with emergency preparedness since 2002 via local health departments (LHDs).
Three focus groups were conducted in May 2005 with 31 Kansas health department employees. Most participants were public health administrators, women, and 40 years or older.
Regionalization was perceived as "absolutely necessary" by participants and resulted in improved collaboration and communication among LHDs. The process supported the development of relationships, trust, and mutual respect among LHDs and other governmental agencies. Participants agreed that LHD functioning has improved the delivery and availability of public health services, increased the efficiency and timeliness of operations, and enhanced public health's visibility in emergency preparedness efforts. Moreover, regionalization added resources to LHDs including personnel, knowledge, technology, technical expertise, and fiscal resources. Dissatisfaction with regionalization was associated with insufficient funding, frustration with changing preparedness guidelines, and differences between state and local expectations. Participants identified four issues necessary to sustain regions: funding, documented benefits, commitment from LHDs and their communities, and engagement from local elected officials.
The regionalization process has been beneficial for LHDs and produced tangible and intangible benefits. Barriers to regionalization expansion should be addressed for additional collaborative ventures.
评估自2002年以来，堪萨斯州各县通过地方卫生部门（LHDs）进行区域化对应急准备工作的影响。
2005年5月对31名堪萨斯州卫生部门员工进行了三个焦点小组访谈。大多数参与者是公共卫生管理人员、女性，年龄在40岁及以上。
参与者认为区域化“绝对必要”，并促进了地方卫生部门之间更好的协作与沟通。这一过程有助于地方卫生部门与其他政府机构建立关系、信任和相互尊重。参与者一致认为，地方卫生部门的运作改善了公共卫生服务的提供和可及性，提高了运营效率和及时性，并增强了公共卫生在应急准备工作中的能见度。此外，区域化给地方卫生部门增加了资源，包括人员、知识、技术、专业技能和财政资源。对区域化的不满与资金不足、对不断变化的准备指南感到沮丧以及州和地方期望的差异有关。参与者确定了维持区域所需的四个问题：资金、记录在案的效益、地方卫生部门及其社区的承诺以及当地民选官员的参与。
区域化进程对地方卫生部门有益，并产生了有形和无形的效益。应解决区域化扩展的障碍，以开展更多合作项目。
