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Public Policy and Administration


Karen L. Shafer


Since 2001, increased policy attention and federal funding mechanisms have required more effective disaster response by government actors and private sector organizations, including the health care system. However, there is limited scholarly evidence documenting which structural elements have been associated with efficacious regional coalitions. This study addressed the gap by examining whether the number of different participating disciplines (a proxy for coalition roles), community setting, and prior weather-related disaster declaration influenced the number of activities (a proxy for coalition responsibilities) conducted by the health care coalition. Social network theory was the theoretical lens with which the study results were used to examine the relational structures within coalitions. The quantitative study was based on archival data from a survey in 2011 of 375 acute care hospitals in the United States. A general linear model analysis was conducted, and results suggest a statistically significant relationship between the number of disciplines and the number of conducted activities. As the number of different disciplines increases in a coalition, so do the different types of conducted activities. Based on the analysis, community setting--urban versus nonurban--and the occurrence of a federally declared, weather-related disaster did not influence the number of coalition activities. This study provides evidence that establishing network structures for health care coalitions will advance the field of health care emergency preparedness and disaster response. The findings from this research may promote social change by guiding future policy development and research necessary to develop resilient and efficacious disaster response systems, resulting in reduced loss of life and injury.