Cost model for core public health services

This study develops a model to estimate the cost of performing a standard core set of public health services. This tool will facilitate the objective comparison of health districts both in terms of the efficiency of service production and the health outcomes associated with those services. This study starts with financial and operating statistics for all Ohio public health districts. This information is linked to socioeconomic variables, such as poverty, race and education. Public health outcomes from Community Health Status Indicators are also linked. Service breadth is measured in order to adjust for districts that provide more than the minimum package. Efficiency is measured by modeling the cost of providing a standard core set of services. Multivariate regression is used to estimate the influence of demographics, health status and departmental characteristics on spending per capita. We test for scale effects by including population. To insure that lower expenses don't come at the cost of lower quality, service effectiveness is measured as the strength of relationship between service mix and outcomes. The resulting model is then re-tested against prior year data to gauge its predictive power. Initial results indicate that poverty and a rural setting are associated with higher costs. The study also finds to cost per capita decreases with population only to a point, so while there are incentives for smaller districts to band together, they do not have to get too big. Overall, this project demonstrates a model that can help optimize the allocation of limited public health resources.