where C, is the marginal cost of the LPHA in county i, N represents the number of cases, LPHA represents LPHA specific characteristics (described below) while county characteristics represents the characteristics of the county where the LPHA operates.
where Cost, represents the cost of the LPHA in county i.
There are a number of LPHA specific factors that may affect the cost of communicable disease surveillance.
Finally, we controlled for the population density and poverty rate of the LPHA jurisdiction.
We interviewed six key informants from public health agencies that represented different CD structures and LPHA sizes (three LPHAs in urban areas and three rural areas).
1 FTE spent on communicable disease surveillance were dropped from the analysis, unless no employee at the LPHA worked on CD more than 0.
To calculate fixed costs, we took the indirect cost recovery rate the LPHA negotiated with the state health department, then multiplied the total agency personnel cost by the agency's indirect rate to calculate a total 2-week cost (fixed and variable costs).
We requested and received permission from each participating individual LPHA to access the data.
Finally, the seasonality variable in the regression shows no significant difference in LPHA costs between the spring and fall seasons.
Indeed, none of the services are fully funded in all LPHAs.
This paper estimates the cost of communicable disease surveillance activities by LPHAs in Colorado and examines factors that cause differences in cost of services across public health delivery settings and systems to estimate economies of scale.
Second, we examine factors in LPHAs that increase or decrease the cost of delivering this core public health service.