scholarly journals Implementing population health management: an international comparative study

2020 ◽  
Vol 34 (3) ◽  
pp. 273-294 ◽  
Author(s):  
Betty Steenkamer ◽  
Esther de Weger ◽  
Hanneke Drewes ◽  
Kim Putters ◽  
Hans Van Oers ◽  
...  

PurposeThe purpose of this paper is to gain insight into how population health management (PHM) strategies can successfully integrate and reorganize public health, health care, social care and community services to improve population health and quality of care while reducing costs growth, this study compared four large-scale transformation programs: Greater Manchester Devolution, Vancouver Healthy City Strategy, Gen-H Cincinnati and Gesundes Kinzigtal.Design/methodology/approachFollowing the realist methodology, this explorative comparative case-study investigated PHM initiatives' key features and participants' experiences of developing such initiatives. A semi-structured interview guideline based on a theoretical framework for PHM guided the interviews with stakeholders (20) from different sectors.FindingsFive initial program theories important to the development of PHM were formulated: (1) create trust in a shared vision and understanding of the PHM rationale to establish stakeholders' commitment to the partnership; (2) create shared ownership for achieving the initiative's goals; (3) create shared financial interest that reduces perceived financial risks to provide financial sustainability; (4) create a learning environment to secure initiative's credibility and (5) create citizens' and professionals' awareness of the required attitudes and behaviours.Originality/valueThe study highlights initial program theories for the implementation of PHM including different strategies and structures underpinning the initiatives. These insights provide a deeper understanding of how large-scale transformation could be developed.

2018 ◽  
Vol 32 (8) ◽  
pp. 934-942 ◽  
Author(s):  
Meghan Hufstader Gabriel ◽  
Danielle Atkins ◽  
Xinliang Liu ◽  
Rebecca Tregerman

Purpose The purpose of this paper is to investigate the relationship between ownership type and population health initiatives adopted by hospitals using the 2015 American Hospital Association data. Design/methodology/approach Hospitals of various sizes, ownership structures and geographic locations are represented in the survey. The outcome variables of interest include measures of hospital population health activities. Findings Findings indicate that nonprofit hospitals are most likely to express commitment to population health and participate in population health activities, with for-profit hospitals being least likely. Implications for policy and practice are discussed. Research limitations/implications This study demonstrates that discrepancies in population health approaches exist across ownership status – particularly, nonprofit hospitals appear to be the most likely to be involved in population health efforts. Practical implications As we continue to push for population health management in the hospital setting, grappling with the definition and purpose of population health management will be essential. Social implications Overall, these results suggest that nonprofit hospitals are more likely to be implementing population health efforts than for-profit or government-owned hospitals. Originality/value Although there are several studies on population health in hospitals, this study is the first to investigate the relationship between ownership type and population health initiatives adopted by hospitals.


2020 ◽  
Vol 28 (3) ◽  
pp. 243-252
Author(s):  
Martin McShane ◽  
Karen Kirkham

PurposeChanges in demographics and disease patterns are challenging health and care systems across the world. In England, national policies have reset the direction of travel for the NHS. Collaboration, integration and personalisation are intended to become prime principles and drivers for new models of care. Central to this is the concept of population health management. This has emerged, internationally, as a method to improve population health. Fundamental for population health management to succeed is the use of integrated data, analytics combined with professional insight and the adoption of a learning health system culture. This agenda reaches beyond the NHS in England and the public health profession to embrace a broad range of stakeholders. By drawing on international experience and early experience of implementation in the United Kingdom, the potential for health and care systems in England to become world leading in population health management is explored.Design/methodology/approachA viewpoint paper.FindingsPopulation health management is a major change in the way health and care systems look at the challenges they are facing. It makes what is happening to individuals, across the continuum of care, the essence for insight and action. The NHS has the components for success and the potential to become world leading in delivery of population health management as part of its integrated care agenda.Originality/valueThis is the first viewpoint paper to set out how population health management contributes to the integrated care agenda in the NHS.


2020 ◽  
Vol 10 (3) ◽  
pp. 169-183
Author(s):  
Nancy Wolff ◽  
Francisco Caravaca Sánchez

Purpose This study aims to examine the behavioral health disorders and trauma exposure are disproportionately represented among incarcerated men. Historically, prisons have been inadequately equipped to respond to the behavioral health needs of incarcerated people. Given the abundance of behavioral health need and the relatively limited availability of prison-based treatment resources, population health management strategies, particularly need stratification, are vital. Design/methodology/approach A sample of 943 male inmates from three Spanish prisons completed a structured questionnaire. Need groups are based on current depression, anxiety and stress symptoms assessed by the DASS-21 and were validated using adverse childhood experiences (ACE), prison-based abuse, prison-based substance use, social support and resilience. Findings Three need groups were identified, namely, minimal, mild/moderate and severe, each representing about one-third of the sample. The severe group had the highest level of all three types of psychological distress, ACE and prison-based adversity and substance use. No statistical differences in social support and resilience were found among the groups. These findings provide a platform for future research to explore how the complexity of behavioral health care need can be identified and stratified for strategic and rational treatment matching. Proving whether a population health management approach improves behavioral health and personal safety outcomes within funding-constrained carceral environments is the next research priority. Originality/value This study is the first to group co-morbid psychological distress into need categories using a social determinants of health framework for validation.


2018 ◽  
Vol 32 (2) ◽  
pp. 224-245 ◽  
Author(s):  
Betty Steenkamer ◽  
Caroline Baan ◽  
Kim Putters ◽  
Hans van Oers ◽  
Hanneke Drewes

Purpose A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate. Design/methodology/approach The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes. Findings In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem. Practical implications The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes. Originality/value This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.


2014 ◽  
Author(s):  
Sarah Klein Klein ◽  
Douglas McCarthy McCarthy ◽  
Alexander Cohen Cohen

Iproceedings ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. e17
Author(s):  
Sashi Padarthy ◽  
Cristina Crespo ◽  
Keri Rich ◽  
Nagaraja Srivatsan

2016 ◽  
Vol 28 (4) ◽  
pp. 245-262 ◽  
Author(s):  
Annalisa Sannino ◽  
Yrjö Engeström ◽  
Johanna Lahikainen

Purpose The paper aims to examine organizational authoring understood as a longitudinal, material and dialectical process of transformation efforts. The following questions are asked: To which extent can a Change Laboratory intervention help practitioners author their own learning? Are the authored outcomes of a Change Laboratory intervention futile if a workplace subsequently undergoes large-scale organizational transformations? Does the expansive learning authored in a Change Laboratory intervention survive large-scale organizational transformations, and if so, why does it survive and how? Design/methodology/approach The paper develops a conceptual argument based on cultural–historical activity theory. The conceptual argument is grounded in the examination of a case of eight years of change efforts in a university library, including a Change Laboratory (CL) intervention. Follow-up interview data are used to discuss and illuminate our argument in relation to the three research questions. Findings The idea of knotworking constructed in the CL process became a “germ cell” that generates novel solutions in the library activity. A large-scale transformation from the local organization model developed in the CL process to the organization model of the entire university library was not experienced as a loss. The dialectical tension between the local and global models became a source of movement driven by the emerging expansive object. Practitioners are modeling their own collective future competences, expanding them both in socio-spatial scope and interactive depth. Originality/value The article offers an expanded view of authorship, calling attention to material changes and practical change actions. The dialectical tensions identified serve as heuristic guidelines for future studies and interventions.


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