Working together? Organizational and market determinants of collaboration between public health and medical care providers.

Abstract

This study examines organizational characteristics and market conditions likely to influence collaborative relationships between public health agencies and community medical care providers. 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. 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. Targeted efforts to facilitate collaboration may be required in settings where institutional and market incentives are lacking.