Collaboration as a Tool for Equity? Reducing Racial and Ethnic Disparities in Healthcare Access

• 成果类型: Article
• 署名作者: Kim, Jiho; Nabatchi, Tina
• 署名单位: Arizona State University; Arizona State University-Downtown Phoenix; Syracuse University
• 刊物名称: PUBLIC ADMINISTRATION REVIEW
• ISSN/ISSBN: 0033-3352; 1540-6210
• DOI: 10.1111/puar.70091
• 发表日期: 2026-09
• 页码: 1340-1358
• 关键词: collaborative governance; health equity; Performance evaluation; governance; management; platforms; services; outcomes

摘要

Despite its importance in theory and practice, little is known about whether, how, when, and for whom a collaborative governance strategy achieves socially equitable outcomes. Using a staggered difference-in-differences design and data from the Behavioral Risk Factor Surveillance System, we analyze how well Oregon counties that adopted collaborative governance bridge racial disparities in healthcare access compared to non-adopting counties. We find that collaborative governance is associated with reducing racial and ethnic disparities in financial barriers to visiting a doctor after 3 years of implementation and that such effects grow stronger over time. In addition, the estimated effect of collaborative governance on having a personal doctor is greatest for Hispanics. This article points to potential benefits of a collaborative governance strategy that designs and scales collaboration through a collaborative platform and collaborative governance regimes, sustains long-term efforts to meet health equity goals, and identifies and serves the most vulnerable populations.