The Influence of Organizational and Community Characteristics on the Cost of Providing Mandated Public Health Services in North Carolina

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Overview

Recent legislation in North Carolina, enacted largely on the basis of presumed cost savings, expands the ability of local health departments (LHDs) to reorganize governance. Practitioners are concerned that these and other changes to public health law increasingly require service provision without reliable cost estimates.  Led by East Carolina University, the North Carolina Public Health Practice-Based Research Network is attempting to address this concern via a three-pronged study that will: 1) estimate and validate the cost per unit of public health service for selected services mandated by North Carolina statute; 2) construct a validated service cost-estimation methodology that can be readily implemented by LHD finance staff; and 3) examine the influence of different delivery system structures on the costs of delivering mandated public health services. Investigators are employing multiple methods to compare cost estimates and to enhance the validity and reliability of the findings. The study will generate an actionable, accessible, and validated methodology for estimating cost of services, thus supporting practitioners in the prioritization of public health activities while also building the evidence base to inform future policies.

Tool

• Public Health Services Costing Tool for Mandatory Environmental Health Services in North Carolina

Presentations

• NC Public Health PBRN DACS Overview (DACS Workshop, September 2013)
• Development and Pilot Test of a Tool to Estimate the Cost of Environmental Health Services at the Local Level (PHSSR Keeneland Conference, April 2014)
• The Cost of Public Health Services: Development and Pilot of a New Tool for Estimating Costs at the Local Level (NACCHO, July 2014)
• The Influence of Organizational and Community Characteristics on the Cost of Providing Mandated Public Health Services in North Carolina (North Carolina Public Health Association Fall Educational Conference, 2014)
• Developing a Tool for Estimating Local Health Departments' Costs of Providing Public Health Services (APHA, November 2014) 
• Developing a Tool for Estimating Local Health Departments' Costs of Providing Public Health Services (PHSSR Research in Progress Webinar, April 2015 recording)

Research Areas

• Financing and Economics
• Costs, Performance, and Outcomes

Contact Us

Nancy Winterbauer, Ph.D., M.S., M.A.
winterbauern@ecu.edu

Lisa Harrison, M.P.H.
lharrison@gvdhd.org