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

Year: 2013
Funding: Delivery and Cost Studies (DACS)
Status: Completed

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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.



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Nancy Winterbauer, Ph.D., M.S., M.A.

Lisa Harrison, M.P.H.