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首页> 外文期刊>Journal of public health management and practice: JPHMP >Resource allocation and funding challenges for regional local health departments in Nebraska
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Resource allocation and funding challenges for regional local health departments in Nebraska

机译：内布拉斯加州地区地方卫生部门的资源分配和资金挑战

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Objective: This study examined the mechanism of resource allocation among member counties and the funding challenges of regional health departments (RHDs) in Nebraska. Design and Study Setting: In 2009, we conducted a qualitative case study of 2 Nebraska RHDs to gain insight into their experiences of making resource allocation decisions and confronting funding challenges. The 2 RHD sites were selected for this case study on the basis of their heterogeneity in terms of population distribution in member counties. Sixteen semistructured in-person interviews were conducted with RHD directors, staff, and board of health members. Interview data were coded and analyzed using NVivo qualitative analysis software (QSR International [Americas] Inc., Cambridge, MA). Results: Our findings suggested that the directors of RHDs play an integral role in making resource allocation decisions on the basis of community needs, not on a formula or on individual county population size. Interviewees also reported that the size of the vulnerable population served by the RHD had a significant impact on the level of resources for RHD's programs. The RHD's decisions about resource allocation were also dependent on the amount and type of resources received from the state. Interviewees identified inadequacy and instability of funding as the 2 main funding challenges for their RHD. These challenges negatively impacted workforce capacity and the long-term sustainability of some programs. Conclusions: Regional health departments may not benefit from better leveraging resources and building a stronger structural capacity unless the issues of funding inadequacy and instability are addressed. Strategies that can be used by RHDs to address these funding challenges include seeking grants to support programs, leveraging existing resources, and building community partnerships to share resources. Future research is needed to identify RHDs optimal workforce capacity, required funding level, and potential funding mechanisms.
机译：目的：本研究考察了内布拉斯加州各成员县之间的资源分配机制以及区域卫生部门（RHD）的资金挑战。设计和研究设置：2009年，我们对两个内布拉斯加州RHD进行了定性案例研究，以了解他们在制定资源分配决策和应对资金挑战方面的经验。根据成员县人口分布的异质性，选择了2个RHD站点进行本案例研究。与RHD主任，员工和卫生局成员进行了16次半结构化的面对面采访。使用NVivo定性分析软件（QSR International [Americas] Inc.，剑桥，马萨诸塞州）对访谈数据进行编码和分析。结果：我们的研究结果表明，RHD的主管在根据社区需求而不是根据公式或县人口规模做出资源分配决策中起着不可或缺的作用。受访者还报告说，RHD为弱势群体服务的人数对RHD计划的资源水平有重大影响。 RHD关于资源分配的决定还取决于从州收到的资源的数量和类型。受访者认为，资金不足和不稳定是他们RHD面临的两个主要资金挑战。这些挑战对劳动力能力和某些计划的长期可持续性产生了负面影响。结论：除非解决资金不足和不稳定的问题，否则区域卫生部门可能无法从更好地利用资源和增强结构能力中受益。 RHD可以用来应对这些资金挑战的策略包括寻求赠款以支持计划，利用现有资源以及建立社区伙伴关系以共享资源。需要进行进一步的研究以确定RHD的最佳劳动力能力，所需的资金水平以及潜在的资金机制。

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