OBJECTIVES: This article presents nationally representative data on the effects of privatization on local health departments (LHDs). METHODS: A stratified representative national sample of 380 LHDs was drawn from a national list of 2488 departments. Telephone interviews were conducted with 347 LHD directors. RESULTS: One half of the directors of LHDs with privatized services reported that privatization helped the performance of core functions. Privatization often resulted in increased time needed for management and administration. More than a third of LHD directors reported concern about loss of control over the performance of privatized functions and services. CONCLUSIONS: Privatization is part of a broader shift toward "managing" rather than directly providing public health services, yet privatization often reduces LHDs' control over the performance of services.
OBJECTIVES: This article presents nationally representative data on the effects of privatization on local health departments (LHDs). METHODS: A stratified representative national sample of 380 LHDs was drawn from a national list of 2488 departments. Telephone interviews were conducted with 347 LHD directors. RESULTS: One half of the directors of LHDs with privatized services reported that privatization helped the performance of core functions. Privatization often resulted in increased time needed for management and administration. More than a third of LHD directors reported concern about loss of control over the performance of privatized functions and services. CONCLUSIONS: Privatization is part of a broader shift toward "managing" rather than directly providing public health services, yet privatization often reduces LHDs' control over the performance of services.