Jonathon P. Leider is with the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN. Jessica Kronstadt, Chelsey K. Saari, and Paul Kuehnert are with the Public Health Accreditation Board (PHAB), Alexandria, VA. Valerie A. Yeager is with the Department of Health Policy and Management at the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN. Kellie Hall, Aaron Alford, and Lori Tremmel Freeman are with the National Association of County and City Health Officials (NACCHO), Washington, DC.
Am J Public Health. 2021 Feb;111(2):301-308. doi: 10.2105/AJPH.2020.306007. Epub 2020 Dec 22.
To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the test and Pearson χ. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [ < .001] and 0% for large [ < .001]). Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB.
通过 2019 年的研究，探讨美国小型地方卫生部门（LHD）申请认证的相关因素。方法：我们使用公共卫生认证委员会（PHAB）的行政数据和国家县和城市卫生官员协会 2013 年、2016 年和 2019 年的档案数据，研究 PHAB 认证申请的相关因素。我们采用潜在类别分析（LCA）对服务组合和规模特征的 LHD 进行分类。采用检验和 Pearson χ 进行双变量比较。截至 2019 年底，有 126 家小型 LHD 申请了认证（8%）。当我们比较不追求认证的原因时，我们观察到不同规模的机构对标准超出 LHD 能力的看法存在差异（小型机构为 47%，中型机构为 22%[<.001]，大型机构为 0%[<.001]）。更多的资金支持、考虑 LHD 规模的不同标准以及认识到服务组合可能影响认证的实用性，这些都是尝试提高小型 LHD 认证率的相关考虑因素。总体而言，小型 LHD 约占尚未向 PHAB 申请的所有 LHD 的 60%。
