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Glen P. Mays, PhD, MPH, Mathematica Policy Research, 600 Maryland Avenue SW, Suite 550, Washington, DC 20024, 202-484-4236, gmays@mathematica-mpr.com and Paul K. Halverson, DrPh, Public Health Practice Program Office/Division of Public Health Systems Development and Research, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K39, Atlanta, GA 30341.
OBJECTIVE: Staffing patterns influence quality of care in clinical settings such as hospitals and nursing homes, but little is known about how staffing influences the performance of public health activities. This study examines how public health staffing levels influence the scope of services performed within communities and the degree to which these services meet established performance standards. METHODS: We use data from 315 local public health systems in seven states that participated in the National Public Health Performance Standards Program (NPHPSP) pilot tests between 1999 and 2001. We linked performance measures with secondary data on public health agency staffing, area health resources, and community characteristics. Multivariate econometric models are used to estimate the effects of staffing levels on the performance of public health services while controlling for other characteristics. RESULTS: Staffing levels have a significant positive effect on the performance of health assessment activities, indicating that a 10% increase in per capita full-time equivalent (FTE) staffing results in an 8.5 percentage-point increase in performance for this domain (p<0.05). The effects of staffing on other performance domains—including regulatory enforcement, public health research, and emergency preparedness—appear less pronounced. Estimates from spline models indicate that staffing levels must reach 75 to 170 FTEs before significant improvements occur in these domains. CONCLUSIONS: Staffing levels play important roles in shaping the availability and quality of public health services. Small public health jurisdictions with limited staff availability may face significant challenges in performing activities that exhibit staffing threshold effects, such as emergency preparedness.
Learning Objectives: Participants in this session will be able to
Keywords: Workforce, Public Health Administration
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.