Mustalish A C, Eidsvold G, Novick L F
Am J Public Health. 1976 Dec;66(12):1149-54. doi: 10.2105/ajph.66.12.1149.
Since the World War I era there has existed within the New York City Department of Health a basic internal struggle between staff directing the bureaus at the central office and the district health officers operating field health centers throughout the city. Recently, in a five-year period, there was a dramatic reorganization of the Department which markedly affected its orientation and programs. In 1972 a new Commissioner initiated a reorganization of the Department which succeeded in decentralizing field operations in contrast to earlier efforts which had failed to reach this objective. The roles of bureaus and districts were redefined, with the latter receiving budgetary authority, authority to supervise personnel, assignment of health managers, and the implementation of a district cost accounting system. While operational decentralization has occurred, policy setting and resource allocation in response to local needs remain central functions.
自第一次世界大战时期以来，纽约市卫生局内部在中央办公室负责各局的工作人员与负责全市各现场卫生中心的地区卫生官员之间一直存在着基本的斗争。最近，在五年时间里，该局进行了一次重大重组，这对其方向和项目产生了显著影响。1972年，一位新局长发起了该局的重组，与早期未能实现这一目标的努力形成对比，这次重组成功地实现了现场业务的分散化。各局和各地区的角色得到了重新定义，后者获得了预算权、人员监督权、卫生管理人员的分配权以及地区成本核算系统的实施权。虽然业务实现了分散化，但根据当地需求进行政策制定和资源分配仍然是核心职能。
