Department of Health Systems Administration, O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC 20057, USA.
J Public Health Manag Pract. 2010 Mar-Apr;16(2):E1-7. doi: 10.1097/PHH.0b013e3181b83475.
Pandemic influenza is an imminent threat, with the April/May 2009 A(H1N1) outbreak as a testament to the potential for rapid transmission and spread of a novel influenza strain. Research has shown that there are great disparities in state pandemic planning; however, little work has been done to assess how health department structure impacts pandemic preparedness. The purpose of this article was to examine the impact of state health department structure on state pandemic influenza plan integration of federal recommendations. The study consisted of a cross-sectional analysis of 41 states and found that structural and strategy-making variables have the greatest impact on pandemic plan inclusion of federal recommendations. Strong, multilayered health department hierarchies and the tenure of senior staff are negatively associated with preparedness, whereas professionalization is positively associated with pandemic plan comprehensiveness. State health departments can take minimally invasive steps to increase their effectiveness in pandemic preparedness by reducing layers of bureaucracy and increasing training for staff.
大流行性流感是一个迫在眉睫的威胁，2009 年 4 月/5 月的 A(H1N1)爆发证明了新型流感毒株具有快速传播和扩散的潜力。研究表明，各州在大流行规划方面存在巨大差距；然而，很少有人致力于评估卫生部门结构如何影响大流行防备工作。本文的目的是研究州卫生部门结构对州大流行性流感计划整合联邦建议的影响。该研究对 41 个州进行了横断面分析，发现结构和决策制定变量对大流行性流感计划纳入联邦建议的影响最大。强大的、多层次的卫生部门层次结构和高级工作人员的任期与防备工作呈负相关，而专业化与大流行性流感计划的全面性呈正相关。州卫生部门可以采取最小侵入性的步骤，通过减少官僚层次和增加工作人员培训，提高其在大流行防备方面的效力。
