Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, USA.
J Public Health Manag Pract. 2012 Nov;18(6):551-60. doi: 10.1097/PHH.0b013e31825b89e4.
CONTEXT/OBJECTIVE: Resource sharing, arrangements between local health departments (LHDs) for joint programs or to share staff, is a growing occurrence. The post-9/11 influx of federal funding and new public health preparedness responsibilities dramatically increased the occurrence of these inter-LHD relationships, and several states have pursed more intrastate collaboration. This article describes the current state of resource sharing among LHDs and identifies the factors associated with resource sharing.
Using the National Association of County & City Health Officials' 2010 Profile Survey, we determined the self-reported number of shared programmatic activities and the number of shared organizational functions for a sample of LHDs. Negative binomial regression models described the relationships between factors suggested by interorganizational theory and the counts of sharing activities.
We examined the extent of resource sharing using 2 different count variables: (1) number of shared programmatic activities and (2) number of shared organizational functions.
About one-half of all LHDs are engaged in resource sharing. The extent of sharing was lower for those serving larger populations, with city jurisdictions, or of larger size. Sharing was more extensive for state-governed LHDs, those covering multiple jurisdictions, states with centralized governance, and in instances of financial constraint.
Many LHDs are engaged in a greater extent of resource sharing than others. Leaders of LHDs can work within the context of these factors to leverage resource sharing to meet their organizational needs.
背景/目的:资源共享,即地方卫生部门之间为联合项目做出的安排或共享员工,这种情况越来越常见。9·11 事件后,联邦资金的大量涌入以及新的公共卫生准备职责大大增加了这些地方卫生部门之间的关系,一些州也在追求更多的州内合作。本文描述了当前地方卫生部门之间资源共享的状况,并确定了与资源共享相关的因素。
利用国家县和城市卫生官员协会 2010 年的概况调查,我们确定了参与共享计划活动的自我报告数量和地方卫生部门共享组织功能的数量。负二项回归模型描述了组织间理论建议的因素与共享活动数量之间的关系。
我们使用了 2 个不同的计数变量来检查资源共享的程度:(1)共享的计划活动数量,(2)共享的组织功能数量。
大约一半的地方卫生部门都在进行资源共享。服务人口较多、城市辖区或规模较大的地方卫生部门的共享程度较低。由州政府管理的地方卫生部门、覆盖多个辖区的地方卫生部门、州政府集中管理的地方卫生部门,以及在财务受限的情况下,共享程度更高。
许多地方卫生部门的资源共享程度高于其他部门。地方卫生部门的领导可以在这些因素的背景下,利用资源共享来满足其组织的需求。