New research is continuing to reveal pathways for improving health and reducing health disparities at reasonable costs through multi-sector public health strategies

Mays, Glen P.

English

University of Kentucky

University of KentuckyUKnowledgeHealth Management and Policy Presentations Health Management and Policy4-8-2014Public Health Services & Systems Research: Takingthe Pulse of the FieldGlen 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 and Medical Administration Commons, and the Health Services ResearchCommonsThis 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., "Public Health Services & Systems Research: Taking the Pulse of the Field" (2014). Health Management and PolicyPresentations. 91.https://uknowledge.uky.edu/hsm_present/91Public Health Services & Systems Research:  Taking the Pulse of the Field Glen Mays, PhD, MPH  University of Kentucky  glen.mays@uky.edu Nat iona l  Coordinat ing  Center  Keeneland Conference on PHSSR   •   Lexington KY  •   8 April 2014 Vicious cycles to learning systems Discover causes &  consequences of variation  in public health delivery Translate evidence for  policy and administrative decisions & advocacy Standardization vs. Customization  in Public Health Delivery Systems Standardization ▼Harmful variation ▼Wasteful variation ▼Inequitable variation ▼Race to the bottom ▲Network externalities: interoperability/coordination Customization ▲Target resources to greatest needs/risks ▲ Tailor approaches to values & preferences of stakeholders ▲ Deploy unique resources & skills to their best purposes  Effectiveness Efficiency Equity Taking stock RWJF-funded PHSSR Studies: 2009-13 Public Health Workforce Studies     8 Enumeration       1 Diversity and Disparities      2 Recruitment and Retention     2 Workforce Competencies       3 Public Health System Structure and Performance Studies  56 System Boundaries and Size     1 Public Health Organization and Governance    8 Interorganizational Relationships and Partnerships   12 Performance Measurement, QI and Accreditation    27 Social Determinants of Health and Health Disparities   8 Financing and Economics     34 Funding levels and effects      4  Financing Mechanisms      10 Costs, Efficiency, and Performance,     20 Information and Technology     18 Assessing & Monitoring Health Outcomes    3 Translation & Dissemination of Evidence-based Strategies   1 Information and Communications Technologies    14 Research Currently Underway 29 studies (3 rounds) PHSSR annual solicitation    7  natural experiment studies  8  mentored research awards   9  predoctoral/postdoctoral research awards 11 PBRN Delivery and Cost studies  4  Quick Strike PBRN studies  See the PHSSR Research Inventory at: http://works.bepress.com/glen_mays/145/  Diffusion of Public Health PBRNs First cohort (December 2008 start-up)Second cohort (January 2010 start-up)Affiliate/Emerging PBRNs (2011-14)PBRNs as Research Engines 31 networks 1593 local public health agencies 35 state agencies 52 academic research units 58 professional & community organizations 60 competitively awarded research projects 68 articles in peer-reviewed journals 221 presentations and conferences & meetings 51 reports & tools in the grey literature  Upcoming research opportunities PBRN Dissemination and Implementation Research to Improve Value (DIRECTIVE) awards Predoctoral/postdoctoral research awards   Quick Strike research studies 2014 PHSSR Annual Solicitation AJPH Call for Papers for Supplement Issue Advancing Methods and Measures Measuring volume, intensity & quality  Measuring costs Measuring complexity in delivery systems  and strategies Estimating value: health & economic effects Accounting for heterogeneity in effects  National Coordinating Center Data & Measurement Development − Periodic census surveys of local and state agencies − National Longitudinal Survey of Public Health Systems − Tracking PH expenditures: US Census of Governments, Uniform Public Health Chart of Accounts − Public Health Activities and Services Tracking (PHAST): compiling existing administrative data across states − Monitoring health reform implementation & effects Dissemination & Translation − Weekly Work in Progress Webinars − Open-access journal: Frontiers in PHSSR − Newsletters, Podcasts, Blogs − Briefings with policy stakeholders Nat iona l  Coordinat ing  Center  Where to from here? Advancing a Culture of Health How best to use public health delivery systems  to improve population health? Engaging communities Mobilizing and steering multi-sector action Aligning public health and medical care Facilitating policy adoption & implementation Targeting & tailoring for equity Addressing social determinants Health System Public Health Agency Legal authority Participation incentives Intergovernmental relationships Strategic Decisions Breadth of organizations Leadership Needs Perceptions Preferences Risks Population & Environment Distribution  of effort Scope of services Staffing levels & mix Governing structure Funding levels & mix Division of responsibility Nature & intensity of relationships Scope of activity Compatibility of missions Resources & expertise Resources Threats Outputs and Outcomes Scale of operations Decision Support •Accreditation •Performance measures •Practice guidelines Reach Effectiveness Timeliness Efficiency Equity Adherence to EBPs Public health’s role in population health Mays et al 2009 Failing to connect Medical Care Delivery  Public Health Delivery • Fragmentation • Duplication • Variability in practice • Limited accessibility • Episodic and reactive care • Insensitivity to consumer values & preferences • Limited targeting of resources to community needs • Fragmentation • Variability in practice • Resource constrained • Limited reach • Insufficient scale • Limited public visibility • Limited evidence base • Adaptation constraints  Inefficient delivery Inequitable outcomes Limited population health impact Toward a “rapid-learning system” in public health Green SM et al. Ann Intern Med. 2012;157(3):207-210 Always Open 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  

Public Health Services & Systems Research: Taking the Pulse of the Field

https://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1118&amp;context=hsm_present

Public Health Services & Systems Research: Taking the Pulse of the Field

Abstract

Similar works

Full text

Available Versions

University of Kentucky