School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.
Department of Prevention and Health Services, Center for Nutrition, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
J Health Organ Manag. 2020 Apr 8;ahead-of-print(ahead-of-print). doi: 10.1108/JHOM-06-2019-0189.
The 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/APPROACH: Following 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.
Five 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/VALUE: The 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.
本文旨在深入了解人口健康管理（PHM）策略如何成功地整合和重组公共卫生、医疗保健、社会关怀和社区服务，以改善人口健康和护理质量，同时降低成本增长。本研究比较了四个大规模转型计划：大曼彻斯特权力下放、温哥华健康城市战略、辛辛那提 Gen-H 和 Gesundes Kinzigtal。
设计/方法/方法：本探索性案例研究采用现实主义方法，调查了 PHM 计划的主要特点和参与者在制定此类计划方面的经验。基于 PHM 的理论框架制定了一份半结构化访谈指南，指导对来自不同部门的利益相关者（20 人）进行访谈。
制定了五个对 PHM 发展很重要的初始计划理论：（1）建立对 PHM 基本原理的共同愿景和理解的信任，以建立利益相关者对伙伴关系的承诺；（2）为实现倡议目标创造共同所有权；（3）创造共同的财务利益，降低感知到的财务风险，提供财务可持续性；（4）创造学习环境，确保倡议的可信度；（5）提高公民和专业人士对所需态度和行为的认识。
原创性/价值：该研究强调了实施 PHM 的初始计划理论，包括为这些举措提供支持的不同策略和结构。这些见解提供了对如何制定大规模转型的更深入理解。
