Funding and Service Delivery in Rural and Urban Local US Health Departments in 2010 and 2016.
Objectives. To investigate differences in funding and service delivery between rural and urban local health departments (LHDs) in the United States. Methods. In this repeated cross-sectional study, we examined rural–urban differences in funding and service provision among LHDs over time using 2010 a...
| Publicado en: | American Journal of Public Health Vol. 110; no. 9; pp. 1293 - 1300 |
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| Autores principales: | , , , |
| Formato: | Artículo |
| Publicado: |
American Public Health Association
Sep2020
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=145072234&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 145072234 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00900036 APH jtl: American Journal of Public Health issn: 00900036 maglogo: N pubinfo: dt: Sep2020 vid: 110 iid: 9 pid: 44 pub: American Public Health Association artinfo: ui: 145072234 10.2105/AJPH.2020.305757 ppf: 1293 ppct: 7 formats: tig: atl: Funding and Service Delivery in Rural and Urban Local US Health Departments in 2010 and 2016. aug: au: Beatty, Kate Heffernan, Megan Hale, Nathan Meit, Michael su: United States. Dept. of Health & Human Services Centers for Medicare & Medicaid Services (U.S.) Community health services Income Medical care Health policy Rural health services Urban health Government aid Cross-sectional method Financial management sug: subj: Community health services Income Medical care Health policy Rural health services Urban health Government aid Cross-sectional method United States. Dept. of Health & Human Services Centers for Medicare & Medicaid Services (U.S.) Community health centres All Other Outpatient Care Centers Residential Mental Health and Substance Abuse Facilities Other local, municipal and regional public administration Other Individual and Family Services Administration of Public Health Programs Portfolio Management Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs) Financial management ab: Objectives. To investigate differences in funding and service delivery between rural and urban local health departments (LHDs) in the United States. Methods. In this repeated cross-sectional study, we examined rural–urban differences in funding and service provision among LHDs over time using 2010 and 2016 National Association of County and City Health Officials data. Results. Local revenue among urban LHDs (41.2%) was higher than that in large rural (31.3%) and small rural LHDs (31.2%; P <.05). Small (20.9%) and large rural LHDs (19.8%) reported greater reliance on revenue from Center for Medicare and Medicaid Services than urban LHDs (11.5%; P <.05). All experienced decreases in clinical revenue between 2010 and 2016. Urban LHDs provided less primary care services in 2016; rural LHDs provided more mental health and substance abuse services (P <.05). Conclusions. Urban LHDs generated more revenues from local sources, and rural LHDs generated more from the Center for Medicare and Medicaid Services and clinical services. Rural LHDs tended to provide more clinical services. Given rural LHDs' reliance on clinical revenue, decreases in clinical services could have disproportionate effects on them. Public Health Implications. Differences in financing and service delivery by rurality have an impact on the communities. Rural LHDs rely more heavily on state and federal dollars, which are vulnerable to changes in state and national health policy. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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