Merrill Jacqueline, Keeling Jonathan, Gebbie Kristine
Department of Biomedical Informatics, Columbia University, Vanderbilt Clinic, New York, NY 10034, USA.
Health Serv Res. 2009 Oct;44(5 Pt 2):1818-41. doi: 10.1111/j.1475-6773.2009.01015.x. Epub 2009 Aug 17.
To identify taxonomy of task, knowledge, and resources for documenting the work performed in local health departments (LHDs).
Secondary data were collected from documents describing public health (PH) practice produced by organizations representing the PH community.
A multistep consensus-based method was used that included literature review, data extraction, expert opinion, focus group review, and pilot testing.
Terms and concepts were manually extracted from documents, consolidated, and evaluated for scope and sufficiency by researchers. An expert panel determined suitability of terms and a hierarchy for classifying them. This work was validated by practitioners and results pilot tested in two LHDs.
The finalized taxonomy was applied to compare a national sample of 11 LHDs. Data were obtained from 1,064 of 1,267 (84 percent) of employees. Frequencies of tasks, knowledge, and resources constitute a profile of PH work. About 70 percent of the correlations between LHD pairs on tasks and knowledge were high (>0.7), suggesting between-department commonalities. On resources only 16 percent of correlations between LHD pairs were high, suggesting a source of performance variability.
A taxonomy of PH work serves as a tool for comparative research and a framework for further development.
确定用于记录地方卫生部门（LHD）所开展工作的任务、知识和资源的分类法。
二手数据收集自代表公共卫生（PH）领域的组织所产生的描述公共卫生实践的文件。
采用了一种基于共识的多步骤方法，包括文献综述、数据提取、专家意见、焦点小组审查和预试验。
术语和概念由研究人员从文件中手动提取、整合，并对其范围和充分性进行评估。一个专家小组确定术语的适用性及其分类层次结构。这项工作由从业者进行了验证，并在两个地方卫生部门进行了预试验。
最终确定的分类法被用于比较11个地方卫生部门的全国样本。从1267名员工中的1064名（84%）获取了数据。任务、知识和资源的频率构成了公共卫生工作的概况。地方卫生部门在任务和知识方面的配对之间约70%的相关性较高（>0.7），表明部门之间存在共性。在资源方面，地方卫生部门配对之间只有16%的相关性较高，表明这是绩效差异的一个来源。
公共卫生工作分类法可作为比较研究的工具和进一步发展的框架。
