This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S

Mays, Glen P.

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University of Kentucky

University of KentuckyUKnowledgeHealth Management and Policy Presentations Health Management and Policy12-6-2013The National Longitudinal Survey of Public HealthSystems: Selected Findings and ApplicationsGlen P. MaysUniversity of Kentucky, glen.mays@cuanschutz.eduRight click to open a feedback form in a new tab to let us know how this document benefits you.Follow this and additional works at: https://uknowledge.uky.edu/hsm_presentPart of the Health Economics Commons, Health Policy Commons, and the Health ServicesResearch CommonsThis Presentation is brought to you for free and open access by the Health Management and Policy at UKnowledge. It has been accepted for inclusionin Health Management and Policy Presentations by an authorized administrator of UKnowledge. For more information, please contactUKnowledge@lsv.uky.edu.Repository CitationMays, Glen P., "The National Longitudinal Survey of Public Health Systems: Selected Findings and Applications" (2013). HealthManagement and Policy Presentations. 49.https://uknowledge.uky.edu/hsm_present/49The National Longitudinal Survey  of Public Health Systems: Selected Findings and Applications Glen Mays, PhD, MPH  University of Kentucky  glen.mays@uky.edu  Nat iona l  Coordinat ing  Center  Acknowledgements Funded by the Robert Wood Johnson Foundation through the Public Health PBRN Program and PHSSR National Coordinating Center Collaborators include Rick Ingram, PhD, Rachel Hogg, MA, Cezar Mamaril, PhD, Andrew Parks, MBA Data: public health production National Longitudinal Survey of Public Health Systems Cohort of 360 communities with at least 100,000 residents Followed over time: 1998, 2006, 2012 Measured from local public health official’s perspective: – Scope: availability of 20 recommended  public health activities – Network: types of organizations  contributing to each activity – Effort: contributed by designated  local public health agency – Quality: perceived effectiveness  of each activity Constructs reflected in the measures Changes in scope and scale of services delivered Intensive margin: effort exerted by governmental public health Extensive margin: other organizations contributing to public health Quality/effectiveness: degree to which services meet community needs Links to other data sources Area Resource File: community and market characteristics, health resources NACCHO Profile data: local public health agency characteristics ASTHO Profile data: state public health agency characteristics U.S. Census of Governments: other state & local spending Consolidated Federal Funds Report: Other federal spending Medicare Cost Report data files: hospital ownership, market share, uncompensated care  Delivery of recommended public health activities 0%10%20%30%40%50%60%70%80%90%100%1998 2006 2012Assurance Policy Assessment% of activities ↑ 10% ↓ 5% National Longitudinal Survey of Public Health Systems, 2012 Delivery of recommended public health activities % of activities National Longitudinal Survey of Public Health Systems, 2012 Variation in Scope of Public Health Delivery Delivery of recommended public health activities, 2012 National Longitudinal Survey of Public Health Systems, 2012 % of activities 0 5% 10& Percent of U.S. communities 20% 40% 60% 80% 100%   Percent of activities performed Organizations contributing  to local public health production -50% -30% -10% 10% 30% 50%Local health agency  Other local government  State health agency  Other state government  Hospitals  Physician practices  Community health centers  Health insurers  Employers/business  Schools   CBOs% Change 2006-2012 Scope of Production 2012 National Longitudinal Survey of Public Health Systems, 2012 National Longitudinal Survey of Public Health Systems, 2012 Inter-organizational relationships in public health delivery systems Do other organizations complement or substitute  for local public health agency effort?  Results from Multivariate GLLAMM Models -0.3 -0.2 -0.1 0 0.1 0.2 0.3 0.4 0.5HospitalsInsurersEmployersPhysiciansCHCsNote: GLLAMM estimates, holding all other variables constant in the model How do other organizations affect the total supply  of public health activities? Results from Multivariate GLLAMM Models -0.3 -0.2 -0.1 0 0.1 0.2 0.3 0.4 0.5 0.6HospitalsInsurersEmployersPhysiciansCHCsNote: GLLAMM estimates, holding all other variables constant in the model Estimated crowd-out in hospital contributions  to public health activities 0%10%20%30%40%50%60%0 5 10 15 20 25Hospital charity care $/1000 population Scope of hospital contributions Note: GLLAMM estimates, holding all other variables constant in the model Effects of economic indicators  on public health spending Elasticity estimates GEE regression estimates with logarithmic link function, controlling for population size, age composition, racial composition, physician and hospital supply, and governance structure  GEE regression estimates with logarithmic link function, controlling for population size, age composition, racial composition, physician and hospital supply, and governance structure  Effects of economic indicators  on public health delivery For More Information Glen P. Mays, Ph.D., M.P.H. glen.mays@uky.edu Supported by The Robert Wood Johnson Foundation Email:    publichealthPBRN@uky.edu Web:       www.publichealthsystems.org Journal:  www.FrontiersinPHSSR.org Archive:  works.bepress.com/glen_mays Blog:       publichealtheconomics.org   Nat iona l  Coordinat ing  Center  

The National Longitudinal Survey of Public Health Systems: Selected Findings and Applications

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The National Longitudinal Survey of Public Health Systems: Selected Findings and Applications

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