An Examination of Health Department Accreditation on Health Outcomes: Commentary and Recommendations

Context: Throughout their public documents, the Public Health Accreditation Board (PHAB) has explicitly stated and implicitly suggested an association between accreditation and population health outcomes. While there is agreement of the inherent value in quality assurance and performance management efforts, there has been no attempt to measure this particular claim. The purpose of this study is to assess if there is a difference between accreditation status of local public health agencies (LPHAs) and population health outcomes. In addition, comments and recommendations are offered to further advance performance management and quality improvement efforts within LPHAs.Design: Using a posttest only non-equivalent groups designed (NEGS) study, accredited or re-accredited LPHAs between 2020 and 2024 and serving a county-specific jurisdiction were randomly matched with a non-accredited peer group. The dependent variables in this study included four widely cited health outcome measures readily accessible from online sources. To determine if a difference exists in these outcomes based on accreditation status, an Independent Samples t-test was used. In order to improve validity, we also assessed the impact of several potentially confounding socio-economic variables.Results: In each of the four population health outcomes noted, no significant difference exists based on accreditation status. Accredited LPHAs were no different than non-accredited LPHAs in terms of their health outcomes. Additionally, no significant differences were noted between several potentially confounding socio-economic variables that could impact health outcomes.Conclusions: Although quality improvement efforts within LPHAs are important, there does not appear to be any association between accreditation status and population health outcomes. While the tenets of the traditional logic model as an organizing framework appear valid, they don’t appear to relate well in this particular application. Commentary and recommendations are provided which discuss how PHAB might adapt to a broader role in LPHA evaluative efforts that may provide more meaning at identifying excellence.