PMID- 37097187
OWN - NLM
STAT- MEDLINE
DCOM- 20230522
LR  - 20230626
IS  - 1550-5022 (Electronic)
IS  - 1078-4659 (Linking)
VI  - 29
IP  - 4
DP  - 2023 Jul-Aug 01
TI  - Age-Adjusted All-Cause Mortality in Counties Served by PHAB-Accredited Local 
      Health Departments Compared With Counties Served by Nonaccredited Local Health 
      Departments: 1999 to 2020.
PG  - 446-455
LID - 10.1097/PHH.0000000000001744 [doi]
AB  - OBJECTIVES: To analyze trends in the age-adjusted all-cause mortality rate (AAMR) 
      from 1999 to 2020 between counties served by a Public Health Accreditation Board 
      (PHAB)-accredited local health department and a nonaccredited local health 
      department to determine whether accreditation impacted the AAMR and whether there 
      were differences in the AAMR preceding the first health departments being 
      accredited in 2013. DESIGN: Descriptive time trends and difference-in-differences 
      analysis was used to explore differences in the AAMR between accredited counties 
      and nonaccredited counties. Propensity score matching was used to develop a 
      control group matched on county characteristics to address confounding. SETTING: 
      A national observational study using data obtained from the Centers for Disease 
      Control and Prevention's Wide-ranging Online Data for Epidemiologic Research, the 
      American Community Survey, and a PHAB data set on accreditation status. 
      PARTICIPANTS: All US counties with data on the AAMR and county characteristics. 
      INTERVENTION: Accreditation by the PHAB. MAIN OUTCOME MEASURE: The AAMR. RESULTS: 
      Difference-in-differences in the AAMR between accredited and nonaccredited 
      counties were stable following the launch of the accreditation program in 2013, 
      except for an improvement in 2020 in the total sample (32.2 deaths per 100 000 
      people, 95% confidence interval: 3.8-60.6, P = .03). Age-adjusted all-cause 
      mortality rates were lower in accredited counties across the 22-year period. This 
      was statistically significant every year in the total sample but only 
      statistically significant in 2020 in the matched sample ( P < .05). Prior to 
      accreditation, the AAMR improved by 24.7 deaths per 100 000 people ( P = .05) and 
      18.0 deaths per 100 000 people ( P = .24) more among accredited counties between 
      1999 and 2008, among the total and matched samples, respectively. CONCLUSION: 
      Currently, PHAB accreditation has not had a substantial impact on the AAMR, and 
      the AAMR was higher among nonaccredited counties preceding the first health 
      departments being accredited in 2013.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Kovach, Kevin A
AU  - Kovach KA
AUID- ORCID: 0000-0001-8195-433
AD  - Kansas Health Institute, Topeka, Kansas.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20230421
PL  - United States
TA  - J Public Health Manag Pract
JT  - Journal of public health management and practice : JPHMP
JID - 9505213
MH  - Humans
MH  - *Public Health
MH  - *Accreditation
COIS- The author declares no conflicts of interest.
EDAT- 2023/04/25 17:42
MHDA- 2023/05/22 06:42
CRDT- 2023/04/25 10:13
PHST- 2023/05/22 06:42 [medline]
PHST- 2023/04/25 17:42 [pubmed]
PHST- 2023/04/25 10:13 [entrez]
AID - 00124784-202307000-00005 [pii]
AID - 10.1097/PHH.0000000000001744 [doi]
PST - ppublish
SO  - J Public Health Manag Pract. 2023 Jul-Aug 01;29(4):446-455. doi: 
      10.1097/PHH.0000000000001744. Epub 2023 Apr 21.