Meyerson Beth E, King Jerry, Comer Karen, Liu Sandra S, Miller Laura
Department of Applied Health Science, Indiana University School of Public Health-Bloomington , Bloomington, IN , USA.
Indiana Public Health Association , Indianapolis, IN , USA.
Front Public Health. 2016 Feb 16;4:21. doi: 10.3389/fpubh.2016.00021. eCollection 2016.
The identification and exploration of moderators of health department accreditation remain limited by current dichotomous conceptualizations of pursuit.
A 2015 survey measured Indiana local health department (LHD) accreditation pursuit and progress, classifying respondents by progress evidence. Covariates included attitudes about the future impact of accreditation on funding and performance, health department size, geography, health outcome ranking, and quality improvement (QI) programing.
Four classifications of accreditation pursuit emerged and were found to have greater association with covariates than standard dichotomous measures. "Active Pursuit" was associated with formal QI programing and a belief that accreditation will impact future funding and performance. "Intent Only" was associated with no QI programing and no completion of accreditation prerequisites. "Discontinued" was associated with the belief that accreditation will not impact future performance. "Not Pursuing" was associated with no interest or plan to complete prerequisites and reported belief that accreditation will not impact future health department funding or performance.
More granular characterizations of accreditation pursuit may improve understanding of influential factors. This measurement framework should be validated in studies of LHDs in other states.
卫生部门认证调节因素的识别与探索仍受当前二分法追求概念的限制。
2015年的一项调查测量了印第安纳州地方卫生部门（LHD）的认证追求与进展情况，根据进展证据对受访者进行分类。协变量包括对认证对资金和绩效未来影响的态度、卫生部门规模、地理位置、健康结果排名以及质量改进（QI）计划。
出现了四种认证追求分类，发现它们与协变量的关联比标准二分法测量更强。“积极追求”与正式的QI计划以及认为认证将影响未来资金和绩效的信念相关。“仅有意向”与没有QI计划且未完成认证先决条件相关。“已中止”与认为认证不会影响未来绩效的信念相关。“未追求”与没有兴趣或计划完成先决条件以及报告认为认证不会影响未来卫生部门资金或绩效相关。
对认证追求进行更细致的描述可能会增进对影响因素的理解。这个测量框架应在其他州地方卫生部门的研究中得到验证。
