A data-driven allocation tool for in-kind resources distributed by a state health department

Objective: The objective of this study was to leverage a state health department's operational data to allocate in-kind resources (children's car seats) to counties, with the proposition that need-based allocation could ultimately improve public health outcomes. Methods: This study used a retrospective analysis of administrative data on car seats distributed to counties statewide by the Georgia Department of Public Health and development of a need-based allocation tool (presented as interactive supplemental digital content, adaptable to other types of in-kind public health resources) that relies on current county-level injury and sociodemographic data. Results: Car seat allocation using public health data and a need-based formula resulted in substantially different recommended allocations to individual counties compared to historic distribution. Conclusions: Results indicate that making an in-kind public health resource like car seats universally available results in a less equitable distribution of that resource compared to deliberate allocation according to public health need. Public health agencies can use local data to allocate in-kind resources consistent with health objectives; that is, in a manner offering the greatest potential health impact. Future analysis can determine whether the change to a more equitable allocation of resources is also more efficient, resulting in measurably improved public health outcomes.研究目标：本研究旨在依托某州卫生部门的运营数据，将实物资源（儿童汽车安全座椅（children's car seats））分配至各郡，核心假设为基于需求的分配策略可最终改善公共卫生结局。 研究方法：本研究对佐治亚州公共卫生部（Georgia Department of Public Health）向全州各郡分发儿童汽车安全座椅的行政数据（administrative data）开展回顾性分析（retrospective analysis），并开发了一款需求导向分配工具（need-based allocation tool）。该工具以交互式补充数字内容（interactive supplemental digital content）形式呈现，可适配其他类型的实物公共卫生资源分配场景，其核心依托当前县级层面（county-level）伤害数据与社会人口统计学数据（sociodemographic data）。 研究结果：相较于历史分配模式，基于公共卫生数据与需求导向公式制定的儿童汽车安全座椅分配方案，为各郡提出的推荐分配额度存在显著差异。 研究结论：结果表明，对儿童汽车安全座椅这类实物公共卫生资源采取普遍可及的分发方式，相较于依据公共卫生需求进行精准分配的模式，其资源分配的公平性（equitable distribution）更低。公共卫生机构（public health agencies）可借助本地数据，按照公共卫生目标开展实物资源分配，即以最具健康影响潜力的方式进行资源配置。 未来研究展望：后续分析可验证，转向更公平的资源分配模式是否兼具更高效率，并能否带来可量化的公共卫生结局（measurably improved public health outcomes）改善。