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Erwin PC et al. - Local health department (LHD) performance measurement provides an opportunity to link inputs, outputs, and outcomes in a manner that should facilitate quality improvement. Since inputs flow from LHDs that vary substantially in size, organization, funding, and other characteristics, it is Reasonable to assume that these variable inputs may affect LHD performance or outcomes. Prospective studies that examine the linkages among LHD performance measurement, accreditation, and outcomes will be important in achieving performance improvement over time.


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