Development of the PHAST model: generating standard public health services data and evidence for decision-making

Bekemeier, Betty; Park, Seungeun

doi:10.1093/jamia/ocx126

Cited by 13 publications

(15 citation statements)

References 24 publications

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“…A study of interoperability requirements across clinical domains within the Veterans Administration (VA) characterized technical challenges in linking national VA infrastructures to local CDSSs, as well as data idiosyncrasies such as standardized medications 70 . The Public Health Activities and Services Tracking (PHAST) group, representing a multistate consortia of researchers and practice partners engaged in public health service delivery, proposed approaches that specified linking local and public health data sources 71 . A review of the requirements to link exposome-acquired data from public health sources to health outcomes that can support discovery suggests that it is early days for effective implementation of such data sources into CDSSs 72 .…”

Section: Population Healthmentioning

confidence: 99%

Advances in Sharing Multi-sourced Health Data on Decision Support Science 2016-2017

Shankar

Anderson

2018

Yearb Med Inform

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Section: Population Healthmentioning

confidence: 99%

Advances in Sharing Multi-sourced Health Data on Decision Support Science 2016-2017

Shankar

Anderson

2018

Yearb Med Inform

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“…also found a positive association between PH expenditures on programs that relate to PH agencies' capabilities and agency performance The framework for these previously reported studies from the early 2000's was based on performance information collected through survey-driven, self-reported evaluation that focused on individual LHDs. A number of these studies noted the need for a standardized national performance assessment instrument ( 22 , 24 , 27 , 28 ), as variations in LHDs' data structure and reporting processes often hinder comparative assessment of agency performance ( 16 , 28 – 30 ).…”

Section: Introductionmentioning

confidence: 99%

“…These cross-cutting infrastructure capabilities include Assessment and Surveillance, Emergency Preparedness and Response, Policy Development and Support, Communications, Community Partnerships Development, Organizational Administrative Competencies, and Accountability and Performance Management ( 20 ). There is growing interest among PH leaders to understand how investments in FC relate to performance in PH functions, so that PH systems can be most responsive to local needs ( 9 , 16 , 21 , 22 ). FC are considered the “building blocks” for LHDs' services such as maternal, child, and family health; immunization programs; and communicable disease control ( 8 , 20 ).…”

Section: Introductionmentioning

confidence: 99%

“…Accreditation recognizes health departments that meet standards designed to assess agencies' readiness to respond to PH needs and facilitates continuous quality improvement and performance ( 36 ). PHAB accreditation serves as a national performance assessment for PH that had been noted as a need in previous studies ( 22 , 24 , 27 , 28 ).…”

Section: Introductionmentioning

confidence: 99%

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Associations Between Local Health Department Expenditures on Foundational Capabilities and PHAB Accreditation Standards Scores

Dada

Bekemeier

Flaxman

et al. 2022

Front. Public Health

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ContextFoundational Capabilities (FC) are the public health (PH) infrastructure areas that are essential for local health departments (LHDs) to support a “minimum package” of programs and services that promote population health. Despite being a critical component of LHD programs, FC are chronically underfunded, and studies specific to the relationship between LHD FC expenditures and their performance—the LHDs' ability to provide essential PH programs and services to their community—have not been previously reported. Public Health Accreditation Board (PHAB) accreditation is a nationally recognized accreditation program for PH agencies. PHAB accreditation assesses LHDs' performance against sets of standards that are based on the 10 essential PH services. Alignment between FC and the PHAB standards presents a means for assessing LHD FC expenditures relative to their performance in PHAB accreditation standards.ObjectivesWe examined the association between LHD total FC expenditures, as well as FC funding allocation patterns, and performance score on selected PHAB accreditation standards.MethodsWe used Bayesian regression methods to estimate the coefficients for the aggregate performance score, and performance scores on individual PHAB standards.ResultsAnalyses showed that a dollar increase in total FC expenditures is associated with a 0.2% increase in the aggregate performance score in selected PHAB standards as well as the performance score on most of the standards examined. LHDs that allocated FC budgets more evenly across FC programs were found to be more likely to have higher scores.ConclusionsInvestment in FC could improve LHD performance scores in PHAB accreditation standards and support LHDs' capability for improving community health outcomes. Allocating available FC resources across the various FC programs could support better LHD performance, as indicated by accreditation scores. This study contributes to advancing the understanding of public health finances in relation to performance and could help guide effective LHD resource allocation.

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“…Historically, complete, detailed, and standardized local data for spending, activities, and health outcomes do not exist for LHD activities, including STDs. 15,16 One methodological challenge is estimating the relationship between spending and STD rates with observational data. Because funding and resources are not randomly allocated to LHDs, any hypothesis regarding STD spending cannot be tested with a randomized study design.…”

Section: Introductionmentioning

confidence: 99%

Analytic approaches to assess the impact of local spending on sexually transmitted diseases

Grembowski

Lim

Pantazis³

et al. 2022

Health Services Research

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Objective To compare the estimated associations between annual sexually transmitted diseases (STD) expenditures per capita and STD incidence rates among Florida and Washington local health departments (LHDs) from 2001 to 2017, using two approaches—a longitudinal regression model with lagged STD spending and a regression model with the Arellano–Bond panel estimator. Data sources Secondary data for LHDs were obtained from Florida and Washington state government offices and combined with county sociodemographic and health system data from the federal government. Study design We examined LHDs in Florida and Washington using a longitudinal panel study design to estimate ecological relationships between annual STD expenditures per capita and annual STD incidence rates from 2001 to 2017, with LHDs as the unit of analysis. We compared two regression models: generalized estimating equations (GEE) and the Arellano–Bond panel estimator (an instrumental variable approach). Data collection The secondary data were combined to build a longitudinal panel database for LHDs in Florida and Washington from 2001 to 2017. Principal findings In the GEE model with both states, greater STD spending in a prior year was associated unexpectedly with greater STD incidence rates in succeeding years. The Arellano–Bond models for both states had the expected inverse associations but were not significant. In the Arellano–Bond models for Florida, a $1 increase in STD spending in previous years was followed by decreases in STD incidence rates ranging between 29 and 58 points in succeeding years (0.09 ≥ p ≥ 0.04). Conclusions In longitudinal panel data for LHDs in two states, the Arellano–Bond estimator, or other instrumental variable approach, is preferred over conventional regression models to obtain unbiased estimates of the relationship between annual STD spending rates and annual STD rates. Future studies will require accurate, standardized, and detailed longitudinal data and rigorous analytic approaches, such as those illustrated in our study.

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Development of the PHAST model: generating standard public health services data and evidence for decision-making

Abstract: Our model is the first of its kind to thoroughly develop a means to guide research and practice in realizing the National Academy of Medicine's recommendation for developing systems to measure and track state and local public health system contributions to population health.

Cited by 13 publications

References 24 publications

Advances in Sharing Multi-sourced Health Data on Decision Support Science 2016-2017

Advances in Sharing Multi-sourced Health Data on Decision Support Science 2016-2017

Associations Between Local Health Department Expenditures on Foundational Capabilities and PHAB Accreditation Standards Scores

Analytic approaches to assess the impact of local spending on sexually transmitted diseases

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