Journal of Community Health

, Volume 9, Issue 2, pp 123–134 | Cite as

Primary care and local health departments: The initiation of a state-sponsored grant program

  • S. Robert Hernandez
  • Arnold D. Kaluzny
Research Reports
  • 13 Downloads

Abstract

This study examines factors that differentiate health service organizations that were successful applicants for a grant program to initiate primary-care services from a matched sample of organizations that did not apply for the program. Factors that were different between the two sets of organizations include the attitudes and behaviors of physicians in the local community, previous success of the organization in obtaining grant support, and employee perceptions of selected organizational and grant program characteristics. These findings suggest that factors both internal and external to the organization are influential in decisions to initiate activities sponsored through grant programs. Implications of these findings for the design of state block grant programs are discussed.

Keywords

Primary Care Health Promotion Local Community Disease Prevention Local Health 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Noll R: The consequences of public utility regulation of hospitals. InControls in Health Care. Washington, DC, NAS/IOM, 1975, p. 25–48.Google Scholar
  2. 2.
    Havinghurst C: Controlling health care costs: Strengthening the private sector's hand.J Health Polit Policy Law 4:471–498, 1977.Google Scholar
  3. 3.
    McClure W:Comprehensive Market and Regulatory Strategies for Medical Care. Excelsior, Minn, Interstudy, report to BHP-HEW (HRA-230-77-0033), 1979.Google Scholar
  4. 4.
    American Hospital Association. Statement to the Subcommittee on Oversight of the House Committee on Ways and Means on the Proposal to Phase Out Professional Standards Review Organizations. March 31, 1981.Google Scholar
  5. 5.
    Nathanson C, Morlock L: Control structure, values, and innovation: A comparative study of hospitals.J Health Soc Behav 21:315–333, 1980.Google Scholar
  6. 6.
    Kaluzny A, Harrison W, Farrow S, et al: Primary care in local health departments: The practitioners' view.North Carolina Medical Journal (in press).Google Scholar
  7. 7.
    Shortell S: Determinants of physician referral rates: An exchange theory approach.Med Care 12:13–31, 1974.Google Scholar
  8. 8.
    Child D:The Essentials of Factor Analysis. New York, Holt, Rinehart and Winston, 1970.Google Scholar
  9. 9.
    Pfeffer J, Salancik G:The External Control of Organizations. New York, Harper and Row, 1978.Google Scholar
  10. 10.
    Terris M: The epidemiologic revolution, National Health Insurance, and the role of health departments.Am J Public Health 66:1155–1163, 1976.Google Scholar
  11. 11.
    Bellin L: Local health departments: A prescription against obsolescence. In A. Levin (ed.)Health Services: The Local Perspective. New York, The Academy of Political Science, 1977.Google Scholar
  12. 12.
    Pickett G: The future of health departments: The governmental presence. InAnnual Review of Public Health. Palo Alto, Annual Reviews Inc., 1980. pp. 297–321.Google Scholar
  13. 13.
    Miller A, Moos M, Kotch J, et al: Role of local health departments in the delivery of ambulatory care.Am J Public Health (January Supplement)71:5–29, 1981.Google Scholar
  14. 14.
    Health Services Research Group, Center for Health Systems Research and Analysis, University of Wisconsin: Development of the index of medical underservice.Health Serv Res 10:168–180, 1975.Google Scholar
  15. 15.
    Zaltman G, Duncan R, Holbeck J:Innovations and Organizations. New York, John Wiley, 1973.Google Scholar
  16. 16.
    Greer A: Advances in the study of diffusion and innovation in health care organizations.Milbank Mem Fund Q 55:505–532, 1977.Google Scholar
  17. 17.
    Kaluzny A, Hernandez SR: Managing organizational change and innovation. In Shortell and Kaluzny (ed.)Organizational Theory and Behavior of Health Institutions. New York, John Wiley, 1983.Google Scholar
  18. 18.
    Kaluzny A: Innovations in health services: Theoretical framework and review of research.Health Serv Res 9:101–120, 1974.Google Scholar
  19. 19.
    Kimberly J: Hospital adoption of innovation: The role of integration into external informational environments.J Health Soc Behav 19:361–373, 1978.Google Scholar
  20. 20.
    Aiken M, Bacharach SB, French JL: Organizational structure, work process, and proposal making in administrative bureaucracies.Academy of Management Journal 23:631–652, 1980.Google Scholar
  21. 21.
    Downs A:Inside Bureaucracy. Boston, Little, Brown and Co., 1966.Google Scholar
  22. 22.
    March JG, Simon HA:Organizations. New York, John Wiley, 1958.Google Scholar
  23. 23.
    Mohr L: Determinants of innovations in organizations.Americann Political Science Review 63:111–126, 1969.Google Scholar
  24. 24.
    Hage J, Dewar R: Elite values versus organizational structure in predicting innovation.Administrative Science Quarterly 18:279–290, 1973.Google Scholar
  25. 25.
    Borgen FH, Seling MJ: Uses of discriminant analysis following MANOVA: Multivariate statistics for multivariate purposes.Journal of Applied Psychology 63:689–697, 1978.Google Scholar
  26. 26.
    Kleinbaum DG, Kupper LL:Applied Regression Analysis and Other Multivariable Methods. North Scituate, MA, Duxbury Press, 1978.Google Scholar
  27. 27.
    Rockoff M, Gordon L, Kleinman, J: Positive programming: The use of data in planning for the Rural Health Initiative.J Community Health 4:204–216, 1979.Google Scholar

Copyright information

© Human Sciences Press 1983

Authors and Affiliations

  • S. Robert Hernandez
  • Arnold D. Kaluzny

There are no affiliations available

Personalised recommendations