Analyzing organizational practices in local health departments.

Few researchers have examined the problem of comparing the performances of local health departments. A contributing factor is the lack of a uniform method for describing the range of public health activities. The Centers for Disease Control and Prevention's Public Health Practice Program Office has identified 10 organizational practices that may be used to assure that the core functions of public health are being carried out at a local health department. The researchers determined the percentage of time devoted to each of the 10 practices by individual employees at a local public health unit in Tampa, FL. They identified the manpower expenditures and hours allocated to each of the 10 practices within the major program divisions of the unit. They found that the largest portion of manpower resources was allocated to implementing programs. A much smaller fraction of agency resources was devoted to analysis of the health needs of the community and to the development of plans and policies. Together, primary care and communicable disease programs accounted for fully three-quarters of the resources, environmental health for 11 percent, and administrative support services for 13 percent. With continuing refinement and modification, the methodology could provide a highly effective basis for describing and analyzing the activities and performances of local health departments.