1 / 15

From Theory to Practice: What drives the core business of public health?

From Theory to Practice: What drives the core business of public health? AcademyHealth 2005 Annual Research Meeting Tina Anderson Smith, MPH June 27, 2005. Research Questions. What is the current core business of Georgia’s governmental public health agency?

camila
Télécharger la présentation

From Theory to Practice: What drives the core business of public health?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. From Theory to Practice: What drives the core business of public health? AcademyHealth 2005 Annual Research Meeting Tina Anderson Smith, MPH June 27, 2005

  2. Research Questions • What is the current core business of Georgia’s governmental public health agency? • What is the “ideal” core business of Georgia’s governmental public health agency?

  3. Principal Findings • Relevant, but not resonant • Practice Paradox • Current core business not aligned with “ideal” core business • Driver Dilemma • Current drivers not aligned with “ideal” drivers • Strategy Shortage • Call for public health leadership and collaboration

  4. State Context • 8.5 million residents + • Relatively younger and more diverse • 13% below Federal Poverty Level • Poor health status, disparities • 1 million + Medicaid • 1 million + uninsured • Rural access issues

  5. Public Health Agency Infrastructure • State agency within Department of Human Resources • 18 District Offices • 159 Local Health Departments • 6,000 DPH Staff • Approximately $624 million budget in 2004 • State public health spending $7 per capita

  6. Methods: Design • Case study approach • Primary Unit: State public health agency • Embedded Units: • District and local agencies • Resource flow, collaboration, structure, strategy, and staff perceptions • Contextual Elements: • Political, economic, financing, and regulatory environment, as well as stakeholder perceptions

  7. Methods • Data sources • Interviews (n=69) • Internal and External Stakeholders • Focus groups (86 participants in 6 groups) • Archival documents • Analysis • Emergent, data-based, inductive • Holistic • Triangulation • Participant Validation

  8. Principal Findings • Relevant, but not resonant • Practice Paradox • Current core business not aligned with “ideal” core business • Driver Dilemma • Current drivers not aligned with “ideal” drivers • Strategy Shortage • Call for public health leadership and collaboration

  9. Practice Paradox

  10. Current Drivers Money Safety Net Uninsured Performance-based budgeting Regulation Leaders’ philosophies Ideal Drivers Need Evidence-based practices State strategy informed by local perspective Local culture Driver Dilemma

  11. State of Georgia Federal Funds Other Funds/TSF Ryan White Hospital ICTF Foundations Division of Public Health County Funds Program GIA Regular GIA Administrative County Health Dept. County Fees District Office Lead County Money Conceptual Flow of Funding

  12. Summary • Practice preferences aligned with the 10 Essential Services • Current core business not aligned with theoretical ideal • Inherent systemic challenges mediate translation of theory into practice • Moving toward “ideal” practice requires addressing larger system drivers

  13. Implications • Understanding practice drivers and their impact on performance is essential • May be difficult in some states to balance essential services without broader policy change • Performance Standards • Accreditation • Emerging role for public health to participate in, even lead, broader policy conversations

  14. Possibilities • “Upstream” interventions to address drivers of practice may emerge as important compliment to more proximal strategies – structure and process – to improve public health performance.

  15. Acknowledgements • Georgia Division of Public Health • Georgia Health Policy Center Team: • Karen Minyard, Ph.D. • Chris Parker, M.D., M.P.H. • Beverly Tyler • Rachel Ferencik, M.P.A.

More Related