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

Objectives. This study examines organizational characteristics and market c onditions likely to influence collaborative relationships between public he alth agencies and community medical care providers. Methods. Public health directors in 60 US counties were surveyed by telepho ne 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. Results. Collaboration was reported among 55% of the hospitals and 64% of t he health centers. Certain forms of collaboration were more likely in marke ts characterized by higher HMO penetration and lower HMO competition. Conclusions. Targeted efforts to facilitate collaboration may be required i n settings where institutional and market incentives are lacking.