Methods: Research brief on possible implications of administrative regionalization across cost-arguments with case study examples.

Results: The Tobacco Settlement Act of 2001 established a comprehensive tobacco use prevention and cessation program within the Pennsylvania Department of Health (PA DOH) with funding through the Master Settlement Agreement (MSA). After the first four years, PA DOH embarked on a process to replace the existing structure of local programming at the county level (48 primary contractors responsible for the 67 counties in Pennsylvania) with a regional-level administrative structure consisting of 8 regions and 8 primary contractors. This move towards regionalization was supported by cost and efficiency-related arguments that suggested increased benefits for Pennsylvania's Tobacco Prevention and Control Program including the emergence of economies of scale, an overall reduction of administrative costs, and greater specialization by tobacco control employees.

Poster outlines potential benefits and downsides of regional level administration for the delivery of tobacco prevention and cessation services, including responsiveness to community needs and differences, changes in resource allocation, standardization of programs and their evaluation, and communication between local and state programs. Poster also presents a strategy to evaluate the impact of regionalization including collecting data about unit costs, labor hours (with an emphasis on administrative hours), and employee specialization.

Conclusions: It is important to analyze the potential consequences, both positive and negative, and actual consequences of administrative change on statewide programs.