Public Health Delivery Systems

Improving awareness of how public health systems are organized, financed and utilized will require vast research and a broad assessment of the current system. At present, U.S. public health systems deliver services through a collection of divergent structural arrangements.

Public health systems are networks of state and local agencies that deliver health care services to communities across the United States. This article summarizes what medical professionals know about the attributes of U.S. public health systems. The authors discuss organizational characteristics across four categories: 1) system boundaries and size; 2) organizational and inter organizational structures; 3) financing and economics; and 4) workforce characteristics.

Key attributes of U.S. public health systems:

  • State and local jurisdictions that define the boundaries of public health systems make it difficult to identify common tendencies.
  • The use of local tax bases to support public health creates disparities in public health spending.
  • What is known about efficiency and cost-effectiveness within public health systems relates to specific interventions rather than delivery systems as a whole.

The ultimate goal of research into the nature of public health systems is improved effectiveness in the delivery of services. Future research might examine nongovernmental organizations and alternative funding mechanisms.

April Issue of Health Affairs Focuses on Patient Safety and Health Care Quality

  1. 1. The Ongoing Quality Improvement Journey
  2. 2. A Road Map for Improving the Performance of Performance Measures
  3. 3. The Trade-Off Among Quality, Quantity, and Cost
  4. 4. 'Global Trigger Tool' Shows that Adverse Events in Hospitals May be Ten Times Greater Than Previously Measured
  5. 5. Preventing Bloodstream Infections
  6. 6. Measuring the Performance of Individual Physicians by Collecting Data from Multiple Health Plans
  7. 7. Measuring Health Care Performance Now, Not Tomorrow
  8. 8. Despite Improved Quality of Care in the Veterans Affairs Health System, Racial Disparity Persists for Important Clinical Outcomes
  9. 9. The Importance of Transitional Care in Achieving Health Reform
  10. 10. An Early Status Report on the Beacon Communities' Plans for Transformation Via Health Information Technology
  11. 11. A Comparative Study of 11 Local Health Department Organizational Networks
  12. 12. Public Health Performance
  13. 13. A Self-Assessment Process for Accreditation Preparedness
  14. 14. Public Health Delivery Systems
  15. 15. A Shot in the Rear, Not a Shot in the Dark
  16. 16. What Predicts Local Public Health Agency Performance Improvement?
  17. 17. Growth of a Scientific Community of Practice
  18. 18. Evolution of Coauthorship in Public Health Services and Systems Research
  19. 19. Resources that May Matter
  20. 20. Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths
  21. 21. Public Health Financial Management Competencies
  22. 22. Decision Science
  23. 23. Public Health Financial Management Needs
  24. 24. Data-Driven Management Strategies in Public Health Collaboratives
  25. 25. Using Geographic Information Systems to Match Local Health Needs with Public Health Services and Programs
  26. 26. Public Health Systems and Services Research
  27. 27. Mapping the Multidisciplinary Field of Public Health Services and Systems Research