The perceived impact of privatization on local health departments.
OBJECTIVE
This article presents nationally representative data on the effects of privatization on local health departments (LHDs).


METHODS
A stratified representative national sample of 380 LHDs was drawn from a national list of 2488 departments. Telephone interviews were conducted with 347 LHD directors.


RESULTS
One half of the directors of LHDs with privatized services reported that privatization helped the performance of core functions. Privatization often resulted in increased time needed for management and administration. More than a third of LHD directors reported concern about loss of control over the performance of privatized functions and services.


CONCLUSIONS
Privatization is part of a broader shift toward "managing" rather than directly providing public health services, yet privatization often reduces LHDs' control over the performance of services.
Keane
Christopher
C
Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA. crkcity@pitt.edu
Marx
John
J
Ricci
Edmund
E
Barron
Gerald
G
D000288:Administrative Personnel; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D009111:Local Government; D020416:Outsourced Services; D011050:Policy Making; D011332:Privatization; D011635:Public Health Administration; D011785:Quality Assurance, Health Care; D012941:Social Responsibility; D014481:United States