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Biomedical subjects

B J Turnock

Publications and source records attributed to B J Turnock.

At least 19 recordsLinked to original sources
PubMed2001

Competency-based credentialing of public health administrators in Illinois.

This article describes an initiative to develop and implement a competency-based credentialing program for public health managers and administrators that is linked with practice performance standards for local public health systems. The Illinois Public Health Administration Certification Board represents an innovative model for credentialing public health workers, placing equal value on competencies secured through education and training and those demonstrated in practice. Competency-based credentialing of public health administrators may have applicability for other segments of the public health workforce.

Administrative Personnel↗
PubMed2000

Can public health performance standards improve the quality of public health practice?

Recent developments suggest that a national public health performance standards program could succeed in improving the quality of public health practice. Public health standards also may be useful for enhancing accountability and strengthening the science base of public health practice. For national public health performance standards to have a substantial influence on the quality of public health practice, several important issues must be addressed. These include agreement as to the ultimate purpose and appropriate unit of measurement, delineation of the specific qualities to be measured, and expansion of strategies to promote widespread use of public health practice standards.

Health Plan Implementation↗
PubMed1999

Final report on public health practice linkages between schools of public health and state health agencies: 1992-1996.

Since 1988 there has been a call for enhanced linkages between schools of public health and public health agencies that has prompted schools of public health to develop public health practice initiatives. The University of Illinois at Chicago School of Public Health conducted surveys of schools of public health and of state public health agencies in 1992 to collect baseline data on practice initiatives undertaken by academe and governmental public health agencies to enhance collaboration; follow-up surveys were undertaken in 1993, 1994 and 1996. This article describes the trends and implications of this survey of practice linkages involving schools of public health and state health agencies.

Cooperative Behavior↗
PubMed1998

Core function-related local public health practice effectiveness.

This article assesses the extent to which the U.S. population in 1995 was being effectively served by public health's three core functions (assessment, policy development, and assurance). A random sample of local health departments (LHDs) stratified by population size and type of jurisdiction was asked to provide their opinion of, as well as indicate performance on 20 core function-related measures of local public health practice. The article concludes that, in 1995, the nation fell far short of its year 2000 national objective, which called for 90 percent of the population to be served by an LHD effectively carrying out public health's core functions. Considerable capacity building and performance improvement is needed within the public health system.

Humans↗
PubMed1998

Impact of Medicaid resources on core public health responsibilities of local health departments in Illinois.

With Illinois' plan to embark on a statewide Medicaid managed care program, the impact of Medicaid resources on core public health responsibilities of local health departments (LHDs) was assessed and found to be substantial. A reduction of $330,000 in core public health activities would likely accompany each $1 million in Medicaid resources lost by these LHDs. Only by actively participating in the planning and implementation of these conversions can public health agencies maintain high productivity and efficiency in addressing core public health responsibilities in their communities.

Budgets↗
PubMed1997

Quality assessment of perinatal regionalization by multivariate analysis: Illinois, 1991-1993.

OBJECTIVE: To identify (1) those elements in the infrastructure of a regionalized perinatal network that have independent effects on the variation in perinatal mortality among nontertiary units (member level I and II hospitals) and (2) shortcomings, if any, in a traditional perinatal data base that impede quality assessment of contemporary regionalized care. METHODS: We analyzed perinatal surveillance data for 3 years, from 1991 to 1993, in the state of Illinois, representing more than 190,000 annual births. Fetal death and neonatal mortality rates for the 97 nontertiary hospitals studied were the dependent variables of interest. Two sets of independent variables were studied, those assessing the maternal sociobehavioral risk of populations served and those assessing the network infrastructure (defined as the facilities of member hospitals and their function within the regionalized network). We used multivariate analysis to partition the variation in hospital rates of perinatal mortality into two components, one attributable to maternal sociobehavioral risk and the other to the network infrastructure. RESULTS: Maternal sociobehavioral risk alone explained 73% of the variation in hospital fetal death rates and 38% of that in hospital neonatal mortality rates. When controlling for maternal sociobehavioral risk, rates of inborn very low birth weight (VLBW) deliveries (P < .001) and neonatal transport (P = .01) had independent effects on the variation in hospital fetal death rate; rates of inborn VLBW deliveries (P < .001), neonatal transport (P < .001), and proportion of VLBW infants transported out (P = .029) had independent effects on the variation in hospital neonatal mortality rate. CONCLUSIONS: In this mature statewide network, the rate of inborn VLBW deliveries exerted the strongest independent effect on variation in level I and II hospital rates of both fetal death and neonatal mortality. However, that there was such a large effect from maternal sociobehavioral risk alone has important public health implications. Additions and modifications to traditional perinatal surveillance are suggested better to assess the quality of regionalization in a contemporary health care environment.

Databases, Factual↗
PubMed1997

Public health practice linkages between schools of public health and state health agencies: results from a three-year survey.

Several recent examinations of the state of public health have called for enhanced linkages between schools of public health and public health agencies, prompting federal health agencies and schools of public health to develop practice initiatives. Surveys of schools of public health and of state public health agencies were conducted in 1992 to collect baseline data on practice links between the two agencies; follow-up surveys were undertaken in 1993 and 1994. Responses reveal that a substantial amount of interaction between schools and agencies has been occurring for some time, but that until recently much of the interaction has been informal and between individuals or departments rather than institution-wide. Both frequency and formalization of such collaborations have increased, reflecting a growing emphasis on public health practice activities at schools of public health together with public health agencies.

Government Agencies↗
PubMed1997

From measuring to improving public health practice.

Efforts to measure public health practice have taken on various forms and focused on different aspects of the system of public health practice over the past century. Before 1990, measurement was primarily based on a series of self-assessment instruments initiated under the auspices of the Committee on Administrative Practice of the American Public Health Association. These instruments emphasized measurement of immediate results of local public health services although they also provided information on local resources and capacity to perform. Following the Institute of Medicine's report in 1988, efforts began to focus on performance related to public health's core functions. These more recent assessments suggest that the system of public health practice must be improved to achieve the targets of effectiveness established for the year 2000. Ultimately, a comprehensive national surveillance system for public health practice will need to both measure and examine the relationships among inputs (resources, capacity, etc), core function-related processes, outputs (services) as well as outcomes.

Health Services Research↗
PubMed1996

Is public health ready for reform? The case for accrediting local health departments.

Reform of the governmental public health system in the United States has been stymied by changes in political, economic, and medical care landscapes since public health was called to action by the Institute of Medicine report in 1988. Despite a new national health objective calling for 90 percent of the population to be served by a local health department effectively addressing public health's three core functions by the year 2000, capacity building initiatives have not been deployed extensively, and there is little likelihood of reaching the year 2000 objective. A national program of accrediting local and state health departments could energize public health capacity building. Accreditation would build on recent initiatives in states like Washington and Illinois, promote wider use of the Assessment Protocol for Excellence in Public Health, and facilitate reform of the public health system around public health's core functions. Key questions addressing the why, how, and who of such an initiative set the stage for consideration of a national accreditation program.

Accreditation↗
PubMed1996

Local health department effectiveness in addressing the core functions of public health: essential ingredients.

OBJECTIVES: Objective 8.14 of the U.S. Healthy People 2000 objectives calls for 90% of the population to be served by a local health department (LHD) which is effectively carrying out the core functions of public health (assessment, policy development, assurance). This study seeks to describe the structural and service characteristics of an effective LHD. METHODS: Data from a 1993 national random sample survey of LHD practice were merged with data from the 1992-1993 National Association of Country and City Health Officials (NACCHO) profile of local health agencies. Using a definition of effectiveness related to the core functions of public health, the correlates of effectiveness were examined for 264 health departments in the matched sample. RESULTS: Effectiveness of local health agencies was not related to jurisdiction size of type. Inputs (structural factors) associated with effectiveness included having a full-time agency head, a larger budget derived from a greater number of funding sources, and a larger number of staff. With respect to outputs (services), effective health departments were also more likely to provide a greater number of services directly, particularly personal preventive and treatment services. CONCLUSIONS: Only a few inputs are correlated with core-function related effectiveness. However, a profile of an effective health department emerges. Effective LHDs appear more likely to have full-time leadership which is able to tap diverse funding sources to provide the mix and match of community and personal prevention and treatment services needed to address community needs and improve the public's health.

Community Health Services↗
PubMed1995

Capacity-building influences on Illinois local health departments.

Illinois local health departments (LHDs) were surveyed in 1992 and again in 1994 in order to assess changes in, influences on, and results of practice performance during this two-year period. Illinois LHDs serving both small and large populations were found to have greatly increased the extent to which they carry out practice measures related to public health's core functions. The Assessment Protocol for Excellence in Public Health (APEXPH) and its Illinois adaptation were cited as the most positive influences on practice performance. LHDs viewed the most significant consequences of participation in needs assessment and planning processes as increased understanding of internal strengths and weaknesses and of community health problems. These findings and implications suggest that significant improvements in LHD practice performance can result from widespread implementation of APEXPH and its derivatives.

Community Health Planning↗
PubMed1994

Building bridges between schools of public health and public health practice.

A 1988 Institute of Medicine report, The Future of Public Health, characterized the current public health system as fragmented, particularly with regard to relationships between public health agencies and academic institutions. As one response to the report, the Health Resources and Services Administration established the Center for the Development of Public Health Practice at the University of Illinois to advance linkages between schools of public health and public health agencies. Surveys of schools of public health and of state health agencies were conducted in 1992 to collect baseline data on the practice links between the two. Responses reveal that there is a substantial amount of informal collaboration between them. Formalization of collaborative activities between schools and agencies is beginning to occur and is expected to expand owing to increased focus on public health practice at schools of public health.

Chicago↗
PubMed1989

Mandatory premarital testing for human immunodeficiency virus. The Illinois experience.

During the first 6 months of legislatively mandated premarital testing for human immunodeficiency virus in Illinois, 8 of 70,846 applicants for marriage licenses were found to be seropositive, yielding a seroprevalence of 0.011%. The total cost of the testing program for 6 months is estimated at $2.5 million or $312,000 per seropositive individual identified. Half of the reported seropositive individuals reported a history of risk behavior. During the same period, the number of marriage licenses issued in Illinois decreased by 22.5%, while the number of licenses issued to Illinois residents in surrounding states increased significantly. We conclude that mandatory premarital testing is not a cost-effective method for the control of human immunodeficiency virus infection.

Costs and Cost Analysis↗