Application of Quality Measurement and Performance Standards to Public Health Systems

Mauer, Barbara; Mason, Marlene; Brown, B. M.

doi:10.1097/00124784-200407000-00010

Cited by 12 publications

(5 citation statements)

References 4 publications

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“…Mays and Smith provide the only evidence to date that changes in expenditures per capita are correlated with changes in health outcomes, with the strongest associations between LHD spending and infant mortality and CVD deaths; mortality from influenza changed in the expected direction but did not reach statistical significance. 18 The association between changes in FTEs per capita and changes in CVD deaths is consistent with cross-sectional studies that have found positive correlations between the number of FTEs and LHD performance and effectiveness 5,6,10,27 and with studies that have specifically examined FTEs per capita. 8 None of these studies measured longitudinal changes in FTEs per capita, and no study directly correlates FTEs per capita with health outcomes.…”

Section: Discussionsupporting

confidence: 67%

“…2 Studies have most often described associations of performance with LHD size, jurisdictional size, and funding: LHDs with larger staffs, serving populations greater than 50 000 persons, and with higher funding per capita were more often higher performing. [3][4][5][6][7][8][9][10][11][12][13][14] Higher performing LHDs also had greater community interaction, a director with higher academic degrees, and leadership functioning within a management team. 5,9,11,15 Only 4 published studies have attempted to link LHD characteristics, activities, or performance to health outcomes.…”

Section: The Association Of Changes In Local Health Department Resourmentioning

confidence: 99%

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The Association of Changes in Local Health Department Resources With Changes in State-Level Health Outcomes

Erwin

Greene²,

Mays³

et al. 2011

Am J Public Health

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We explored the association between changes in local health department (LHD) resource levels with changes in health outcomes via a retrospective cohort study. We measured changes in expenditures and staffing reported by LHDs on the 1997 and 2005 National Association of County and City Health Officials surveys and assessed changes in state-level health outcomes with the America's Health Rankings reports for those years. We used pairwise correlation and multivariate regression to analyze the association of changes in LHD resources with changes in health outcomes. Increases in LHD expenditures were significantly associated with decreases in infectious disease morbidity at the state level (P = .037), and increases in staffing were significantly associated with decreases in cardiovascular disease mortality (P = .014), controlling for other factors.

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Section: Discussionsupporting

confidence: 67%

Section: The Association Of Changes In Local Health Department Resourmentioning

confidence: 99%

The Association of Changes in Local Health Department Resources With Changes in State-Level Health Outcomes

Erwin

Greene²,

Mays³

et al. 2011

Am J Public Health

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“…LHDs often serve as an important first point of contact for recipients of opioid-focused services and coordinate a variety of activities and programs between various stakeholders in their communities (Scutchfield, Knight, Kelly, Bhandari, & Vasilescu, 2004). Echoing the capacity perspective, more staff resources is a key indicator in identifying high performing health departments (Handler & Turnock, 1996; Kennedy, 2003; Mauer, Mason, & Brown, 2004). Although these studies satisfy the resource-perspective, how are these resources translated into practice?…”

Section: Can Administrative Capacity Help Address Wicked Problems?mentioning

confidence: 99%

Can Administrative Capacity Address Wicked Problems? Evidence From the Frontlines of the American Opioid Crisis

McCrea

2019

Administration & Society

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What is the link between administrative capacity and wicked problems? Previous literature links capacity to standardized performance outputs, but little is known on the link between capacity and highly complex policy settings. This study examines health outcomes of the opioid crisis—a wicked problem with interdependencies across different drugs with multiple legal and illegal pathways for abuse and dependence. If capacity matters for wicked problems, administrative action should decompose the larger wicked problem into smaller, more achievable solutions. The findings suggest that administrative capacity may allow public organizations to simultaneously manage drug outcomes across the legal and illegal market.

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“…Existing QI literature often focuses on the internal dynamics of health departments and how they contribute to performance. 2,3,13-15 However, fewer studies examine information use as a cognitive process for the purposes of performance and QI. It is clear from other fields of study that simply having operational data does not ensure performance improvement.…”

Section: Introductionmentioning

confidence: 99%

Framing Bias in the Interpretation of Quality Improvement Data: Evidence From an Experiment

Ballard

2019

Int J Health Policy Manag

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Background: A growing body of public management literature sheds light on potential shortcomings to quality improvement (QI) and performance management efforts. These challenges stem from heuristics individuals use when interpreting data. Evidence from studies of citizens suggests that individuals’ evaluation of data is influenced by the linguistic framing or context of that information and may bias the way they use such information for decision-making. This study extends prospect theory into the field of public health QI by utilizing an experimental design to test for equivalency framing effects on how public health professionals interpret common QI indicators. Methods: An experimental design utilizing randomly assigned survey vignettes is used to test for the influence of framing effects in the interpretation of QI data. The web-based survey assigned a national sample of 286 city and county health officers to a "positive frame" group or a "negative frame" group and measured perceptions of organizational performance. The majority of respondents self-report as organizational leadership. Results: Public health managers are indeed susceptible to these framing effects and to a similar degree as citizens. Specifically, they tend to interpret QI information presented in a "positive frame" as indicating a higher level of performance as the same underlying data presenting in a "negative frame." These results are statistically significant and pass robustness checks when regressed against control variables and alternative sources of information. Conclusion: This study helps identify potential areas of reform within the reporting aspects of QI systems. Specifically, there is a need to fully contextualize data when presenting even to subject matter experts to reduce the existence of bias when making decisions and introduce training in data presentation and basic numeracy prior to fully engaging in QI initiatives.

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Application of Quality Measurement and Performance Standards to Public Health Systems

Cited by 12 publications

References 4 publications

The Association of Changes in Local Health Department Resources With Changes in State-Level Health Outcomes

The Association of Changes in Local Health Department Resources With Changes in State-Level Health Outcomes

Can Administrative Capacity Address Wicked Problems? Evidence From the Frontlines of the American Opioid Crisis

Framing Bias in the Interpretation of Quality Improvement Data: Evidence From an Experiment

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