Improving Public Health System Performance Through Multiorganizational Partnerships - Preventing Chronic Disease: November 2010: 10_0088

http://www.cdc.gov/pcd/issues/2010/nov/images/cover_nov10.jpg
November 2010
Volume 7: Issue 6
ISSN: 1545-1151
SPECIAL TOPIC
Improving Public Health System Performance Through Multiorganizational Partnerships
Glen P. Mays, MPH, PhD; F. Douglas Scutchfield, MD

Suggested citation for this article: Mays GP, Scutchfield FD. Improving public health system performance through multiorganizational partnerships. Prev Chronic Dis 2010;7(6). http://www.cdc.gov/pcd/issues/2010/nov/10_0088.htm. Accessed [date].

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Abstract

Public health activities in the United States are delivered through multiple public and private organizations that vary widely in their resources, missions, and operations. Without strong coordination mechanisms, these delivery arrangements may perpetuate large gaps, inequities, and inefficiencies in public health activities. We examined evidence and uncertainties concerning the use of partnerships to improve the performance of the public health system, with a special focus on partnerships between public health agencies and health care organizations. We found that the types of partnerships likely to have the largest and most direct effects on population health are among the most difficult, and therefore least prevalent, forms of collaboration. High opportunity costs and weak and diffuse participation incentives hinder partnerships that focus on expanding effective prevention programs and policies. Targeted policy actions and leadership strategies are required to illuminate and enhance partnership incentives.


Introduction

Public health activities in the United States are implemented through the combined actions of multiple government and private organizations that vary widely in missions, resources, and operations. Public health agencies serve as focal points, but these agencies rely heavily on their ability to inform and influence the work of others. Public health delivery systems thus are complex and adaptive systems that operate through the interactions of multiple heterogeneous actors. Without strong coordination mechanisms, these systems may perpetuate large gaps and inequities in the availability and effectiveness of public health activities and substantial inefficiencies in performance (1). In other sectors, interorganizational partnerships and alliances have been used to coordinate action in ways that improve information flow, reduce duplication of effort, achieve economies of scale and scope, and accelerate adoption of effective practices (2).

Recognizing these issues, the Institute of Medicine’s 2003 review of the nation’s public health system called for “a new generation of intersectoral partnerships” that span the many different sectors of organizational activity that affect population health and that coordinate activities across these sectors (3). Partnerships that integrate medical care and public health approaches to achieve comprehensive health improvement are particularly important. In this article, we examine evidence, uncertainties, and emerging opportunities regarding the use of partnerships to improve the public health system.

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Preventing Chronic Disease: November 2010: 10_0088