Working together? Organizational and market determinants of collaboration between public health and medical care providers.
OBJECTIVE
This study examines organizational characteristics and market conditions likely to influence collaborative relationships between public health agencies and community medical care providers.


METHODS
Public health directors in 60 US counties were surveyed by telephone concerning their relationships with area community hospitals (n = 263) and community health centers (n = 85). Multivariate models were used to estimate the effects of organizational and market characteristics on collaboration.


RESULTS
Collaboration was reported among 55% of the hospitals and 64% of the health centers. Certain forms of collaboration were more likely in markets characterized by higher HMO penetration and lower HMO competition.


CONCLUSIONS
Targeted efforts to facilitate collaboration may be required in settings where institutional and market incentives are lacking.
Halverson
P K
PK
Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Ga., USA.
Mays
G P
GP
Kaluzny
A D
AD
D001291:Attitude of Health Personnel; D003151:Community Health Centers / Q000458:organization & administration*; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D004465:Economic Competition; D019981:Health Care Sector; D006279:Health Maintenance Organizations / Q000458:organization & administration; D006302:Health Services Research; D006764:Hospitals, Community / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D016015:Logistic Models; D015999:Multivariate Analysis; D015279:Organizational Culture; D010067:Ownership; D008486:Physician Executives / Q000523:psychology*; D011635:Public Health Administration; D011795:Surveys and Questionnaires; D014481:United States