Department of Public Health and Primary Care/ Health Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands.
BMC Health Serv Res. 2023 Aug 25;23(1):910. doi: 10.1186/s12913-023-09915-5.
Despite international examples, it is unclear for multisector initiatives which want to sustainably improve the health of a population how to implement Population Health Management (PHM) and where to start. Hence, the main purpose of this research is to explore current literature about the implementation of PHM and organising existing knowledge to better understand what needs to happen on which level to achieve which outcome.
A scoping review was performed within scientific literature. The data was structured using Context-Mechanism-Outcome, the Rainbow model of integrated care and six elements of PHM as theoretical concepts.
The literature search generated 531 articles, of which 11 were included. Structuring the data according to these three concepts provided a framework that shows the skewed distribution of items that influence the implementation of PHM. It highlights that there is a clear focus on normative integration on the organisational level in 'accountable regional organisation'. There is less focus on the normative integration of 'cross domain business model', 'integrated data infrastructure', and 'population health data analytics', and overall the perspective of citizen and professionals, indicating possible gaps of consideration.
A first step is taken towards a practical guide to implement PHM by illustrating the depth of the complexity and showing the partial interrelatedness of the items. Comparing the results with existing literature, the analysis showed certain gaps that are not addressed in practice, but should be according to other frameworks. If initiators follow the current path in literature, they may be missing out on some important components to achieve proper implementation of PHM.
尽管有国际范例,但对于想要可持续改善人口健康的多部门倡议而言,如何实施人口健康管理(PHM)以及从何处入手仍不清楚。因此,这项研究的主要目的是探索关于 PHM 实施的现有文献,并对现有知识进行组织,以更好地理解在哪个层面上需要发生什么,以实现何种结果。
在科学文献中进行了范围界定审查。使用 Context-Mechanism-Outcome、综合护理的彩虹模型和 PHM 的六个要素作为理论概念对数据进行结构化。
文献检索生成了 531 篇文章,其中有 11 篇被纳入。根据这三个概念对数据进行结构化提供了一个框架,展示了影响 PHM 实施的项目的偏态分布。它强调了在“负责的区域组织”中对组织层面的规范整合的明确关注。对“跨领域业务模式”、“综合数据基础设施”和“人口健康数据分析”的规范整合关注较少,总体上对公民和专业人员的观点关注较少,表明可能存在考虑不充分的情况。
通过说明复杂性的深度并展示项目之间部分的相互关系,朝着实施 PHM 的实用指南迈出了第一步。将结果与现有文献进行比较,分析表明存在一些实践中未涉及但根据其他框架应该涉及的差距。如果发起者遵循文献中的当前路径,他们可能会错过一些实现适当 PHM 实施的重要组成部分。