The Evolution of Public Health–Hospital Collaboration in the United States

Abstract

Collaboration refers to relationships in which two or more independent parties voluntarily decide to work together to address a common purpose. Collaborative arrangements take many forms, from informal, nonbinding agreements for information sharing on topics of mutual interest to formal alliances that entail the creation of new organizational entities, substantial financial investments, and long-term legal commitments. In the health field, the spectrum of collaborative endeavors is wide and diverse. An important segment of this spectrum consists of collaborative arrangements among public health agencies, hospitals, and other parties (e.g., school systems and businesses) that unite to address one or more health issues and improve the culture of health in their communities. Evidence suggests that such collaborative partnerships can have beneficial collective impact. 1-3 Our work focuses on public health-health care collaboration and not the broader issue of public health-health care integration. The history of collaboration between the public health and hospital sectors is mixed at best; although close, mutually beneficial partnerships exist in some U.S. communities, they are not prevalent across the United States. We offer our perspective on past collaboration between the public health and hospital sectors, review emerging patterns, and discuss future prospects for these patterns.

Evidence that collaborative action between local health departments and nonprofit hospitals helps foster healthy behaviors in communities: a multilevel study

“…Accordingly, we interpreted LHD responses indicating a joint effort for implementing community health needs assessments to be reflective of relatively long-standing relationships (or lack thereof) between an LHD and one or more nonprofit hospitals in a community. While this variable lacked granularity in terms of the nature, strength, and scale of LHD-hospital collaboration (e.g., the content of implementation plans was not known), previous research suggests that any level of meaningful, ongoing collaboration between these two sectors within the same community is uncommon [ 24 ]. Thus, we constructed this variable to measure if such collaboration is associated with positive individual-level health outcomes.…”

Using a positive deviance framework to identify Local Health Departments in Communities with exceptional maternal and child health outcomes: a cross sectional study

“…There is some evidence that partnerships may be associated with better health outcomes and LHD performance; [ 33 ] however, robust metrics for studying the strength of LHD partnerships have yet to be developed. Prybil et al recently noted best practices in hospital-public health collaborations, [ 34 ] some of which may be occurring in these positive deviant communities. While some positive deviant jurisdictions in our study may not have a hospital, they may be applying partnership strategies with private providers and community based organizations, leading to exceptional outcomes.…”

Population Health Measurement: Applying Performance Measurement Concepts in Population Health Settings

“…Moreover, they recommend that to enable objective, evidence-based evaluation of a partnership’s progress in achieving its mission and goals and to fulfill its accountability to key stakeholders, the partnership’s leadership should specify the community health measures they want to address, the particular objectives and targets they intend to achieve, and the metrics and tools they will use to track and monitor progress. 44 …”

“…For example, in their analysis of 12 successful partnerships between hospitals and public health, Prybil and colleagues found that these partnerships continue to be challenged in developing objectives and metrics and in demonstrating their linkages with the overall measures of population health on which they have chosen to focus. 9 Thus, the goal of this paper is to summarize the current status of population health measurement and suggest a number of ways to advance the national dialogue on this critical issue. There is no single answer to this question—rather, different measurement approaches are necessary depending on purpose and context.…”