Struijs Jeroen N, Drewes Hanneke W, Heijink Richard, Baan Caroline A
Harvard School of Public Health, Department of Health Management and Policy, United States; National Institute of Public Health and the Environment, Center for Nutrition, Prevention and Health Services, Department for Quality of Care and Health Economics, The Netherlands.
National Institute of Public Health and the Environment, Center for Nutrition, Prevention and Health Services, Department for Quality of Care and Health Economics, The Netherlands.
Health Policy. 2015 Apr;119(4):522-9. doi: 10.1016/j.healthpol.2014.12.003. Epub 2014 Dec 10.
Many countries face the persistent twin challenge of providing high-quality care while keeping health systems affordable and accessible. As a result, the interest for more efficient strategies to stimulate population health is increasing. A possible successful strategy is population management (PM). PM strives to address health needs for the population at-risk and the chronically ill at all points along the health continuum by integrating services across health care, prevention, social care and welfare. The Care Continuum Alliance (CCA) population health guide, which recently changed their name in Population Health Alliance (PHA) provides a useful instrument for implementing and evaluating such innovative approaches. This framework is developed for PM specifically and describes the core elements of the PM-concept on the basis of six subsequent interrelated steps. The aim of this article is to transform the CCA framework into an analytical framework. Quantitative methods are refined and we operationalized a set of indicators to measure the impact of PM in terms of the Triple Aim (population health, quality of care and cost per capita). Additionally, we added a qualitative part to gain insight into the implementation process of PM. This resulted in a broadly applicable analytical framework based on a mixed-methods approach. In the coming years, the analytical framework will be applied within the Dutch Monitor Population Management to derive transferable 'lessons learned' and to methodologically underpin the concept of PM.
许多国家面临着持续的双重挑战，即提供高质量的医疗服务，同时保持医疗系统的可负担性和可及性。因此，人们对采用更高效策略来促进人群健康的兴趣与日俱增。一种可能成功的策略是人群管理（PM）。人群管理致力于通过整合医疗保健、预防、社会护理和福利等各方面的服务，满足处于健康连续体各个阶段的高危人群和慢性病患者的健康需求。护理连续体联盟（CCA）的人群健康指南最近更名为人群健康联盟（PHA），它为实施和评估此类创新方法提供了一个有用的工具。该框架是专门为人群管理开发的，并基于六个相互关联的后续步骤描述了人群管理概念的核心要素。本文的目的是将CCA框架转化为一个分析框架。我们完善了定量方法，并实施了一组指标来衡量人群管理在“三重目标”（人群健康、医疗质量和人均成本）方面的影响。此外，我们增加了一个定性部分，以深入了解人群管理的实施过程。这就形成了一个基于混合方法的广泛适用的分析框架。在未来几年，该分析框架将应用于荷兰人群管理监测项目，以得出可借鉴的“经验教训”，并从方法学上支持人群管理的概念。
