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Open Access
Article
Publication date: 27 April 2020

Martin McShane and Karen Kirkham

Changes 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…

2915

Abstract

Purpose

Changes 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/approach

A viewpoint paper.

Findings

Population 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/value

This is the first viewpoint paper to set out how population health management contributes to the integrated care agenda in the NHS.

Details

Journal of Integrated Care, vol. 28 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 October 2018

Meghan Hufstader Gabriel, Danielle Atkins, Xinliang Liu and Rebecca Tregerman

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…

Abstract

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.

Details

Journal of Health Organization and Management, vol. 32 no. 8
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 3 August 2012

Helmut Hildebrandt, Timo Schulte and Brigitte Stunder

The purpose of this article is to share emerging evidence about the qualitative and economic benefits of integrating care, based on an innovative population‐based approach across…

1066

Abstract

Purpose

The purpose of this article is to share emerging evidence about the qualitative and economic benefits of integrating care, based on an innovative population‐based approach across a small region of Germany. The article aims to discuss the features that have similarities to the international discussion around managed care and accountable care, e.g. the use of a “gain share” model to incentivise all the main partners, and the quite unique approaches derived from a public health background. The operation of Gesundes Kinzigtal could be considered as a benchmark for the “Clinical commissioning groups” that are in development as a result of the Health and Social Care Act 2012 in the UK.

Design/methodology/approach

A regional health management company in cooperation with the physicians' network in the region and two health insurance providers has reorganized the delivery of care across all sectors towards improving the health of the population. The key features of the approach are summarised in the paper. Administrative and medical data obtained from the health insurance providers and from routine management monitoring are used to evaluate the benefits of the approach compared to control groups.

Findings

The project is beginning to demonstrate that this model of integrated care can be effective, with cost benefits and savings for the partners, and improved health outcomes for the population.

Research limitations/implications

The project started in 2006, and only early results of the first three to four years are reported here because of the use of claims data of health insurers.

Originality/value

The approach is an innovative model of integration in its combination of logistical re‐engineering of care processes, IT integration, public health and prevention measures. Its evaluation through an ambitious series of studies may have long‐term relevance for the organisation and management of care services internationally.

Article
Publication date: 20 October 2020

Constance Dumalanede, Kavita Hamza and Marielle Payaud

This study aims to highlight the processes that private organisations implement to improve access to health care services for low-income communities in Brazil.

Abstract

Purpose

This study aims to highlight the processes that private organisations implement to improve access to health care services for low-income communities in Brazil.

Design/methodology/approach

A qualitative research based on a comparative case study was conducted in São Paulo. A for-profit organisation and a not-for-profit one were compared to scrutinise how they adapt themselves to the social context they are embedded in; while improving their service accessibility.

Findings

Both kinds of organisations have succeeded to reach their goal of improving the access and reducing the time frame of health care services to low-income populations. Their initial business model (BM) makes them face their own challenges that they face with different strategies. It affects their way of communicating, their organisational culture, the patients’ expectations and their level of inclusiveness.

Research limitations/implications

The research is context-dependent because of the specific conditions of the health public system in Brazil. When shaping health care BMs, the national context must be taken into account and the service marketing components should be used to enhance patients’ value co-creation in the health care service delivery process.

Practical implications

The research gives insights to organisations that seek to adapt their BM to improve health-care access to low-income populations.

Social implications

Health-care access plays a key role in improving populations’ living conditions and reach one of the sustainable development goals of the United Nation.

Originality/value

Health care services access at the bottom of the pyramid remains under-studied. The paper brings value by comparing for-profit and non-profit organisations, which have the same social goal of improving health-care access to low-income populations while developing different practices to deal with their own challenges.

Details

Society and Business Review, vol. 15 no. 3
Type: Research Article
ISSN: 1746-5680

Keywords

Article
Publication date: 4 June 2018

Richard Q. Lewis and Nav Chana

The purpose of this paper is to consider how the evolving concept of the “primary care home” (PCH) that is developing in England might be an effective vehicle for the delivery of…

Abstract

Purpose

The purpose of this paper is to consider how the evolving concept of the “primary care home” (PCH) that is developing in England might be an effective vehicle for the delivery of the goals of “population health”. The authors examine evidence from earlier initiatives to achieve similar objectives of primary care-led health system planning and care integration to understand relevant lessons for the PCH.

Design/methodology/approach

This paper is based on a descriptive review of the PCH using documentary sources and a non-systematic review of literature relating to primary care commissioning initiatives and recent initiatives to deliver general practice services on a larger scale.

Findings

The PCH is likely to bring forth relatively high engagement from general practitioners due to its neighbourhood scale, voluntary nature and its focus on professional partnership, personalisation of care and outcomes. It is important that participants have sufficient autonomy to act and that financial incentives are aligned with the goals of population health. It is also important that, unlike some earlier primary care initiatives, the PCH is given time to develop to maturity.

Originality/value

The PCH is a recent phenomenon that is developing in England and elsewhere. This paper locates the PCH within a historical context and draws conclusions from a relevant evidence base.

Details

Journal of Integrated Care, vol. 26 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 29 February 2024

Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and…

Abstract

Purpose

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

Design/methodology/approach

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Findings

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

Originality/value

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

Details

Journal of Humanitarian Logistics and Supply Chain Management, vol. 14 no. 2
Type: Research Article
ISSN: 2042-6747

Keywords

Open Access
Article
Publication date: 26 March 2018

Betty Steenkamer, Caroline Baan, Kim Putters, Hans van Oers and Hanneke Drewes

A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired…

2551

Abstract

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.

Details

Journal of Health Organization and Management, vol. 32 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 4 December 2017

Bita A. Kash, Paul Ogden, Elizabeth Popp, Melissa Shaffer and Jane Bolin

The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the…

1524

Abstract

Purpose

The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the burden of chronic disease in a population-based approach.

Design/methodology/approach

A systematic literature review was conducted and identified 1,880 published records through PubMed using 26 search terms. After abstract and full-text review, 70 articles remained as potential models.

Findings

Although there is already a severe shortage of physicians in Texas, emerging practice patterns and choices among physicians are likely to erode access to primary care services in the state. Health-care leaders are encouraged to consider models such as complex adaptive systems for team-based care, pharmacist hypertension care management program and combined nurse-led care management with group visit structure.

Research limitations/implications

As with any study, this research has its limitations; for example, models that might work in one state, or under a unique state-funded academic medical center, might not be “do-able” in another state within the nuances of a different funding mechanism.

Practical implications

Results of this research provide a model for implementing IPCM for the state of Texas first and will guide IPCM planning and implementation in other states.

Originality/value

This study is “land grant-centric” and focused on carrying out the mission of a major, top-tier research university with an emerging college of medicine at an academic medical center.

Details

International Journal of Innovation Science, vol. 9 no. 4
Type: Research Article
ISSN: 1757-2223

Keywords

Article
Publication date: 17 May 2021

Ye In (Jane) Hwang, Natasha Ann Ginnivan, Paul Leslie Simpson, Susan Baidawi, Adrienne Withall, Brie Williams and Tony Butler

The purpose of this commentary is to draw upon available literature and practices related to COVID-19 and management of older incarcerated adults in Australia to highlight key…

1505

Abstract

Purpose

The purpose of this commentary is to draw upon available literature and practices related to COVID-19 and management of older incarcerated adults in Australia to highlight key matters for better risk management and care of this population during this and future infectious disease pan/epidemics.

Design/methodology/approach

The present commentary draws on current policies, practices and literature regarding the health, needs and management of older incarcerated adults in Australia to discuss risk, care and early release for this population during the COVID-19 pandemic.

Findings

Incarcerated persons experience poorer health and accelerated age-related decline compared to those in the general community. The present situation offers the opportunity to fill knowledge and practice gaps, including policies for staff training, identification of dementia and cognitive decline, assessment of mobility issues, addressing barriers to health-seeking, possibilities of medical or compassionate release, risk assessment and release protocols and post-release needs.

Practical implications

While Australian prisons have acknowledged the vulnerability of older persons, more focused adaptation of COVID-19-related policies to consider adults as young as 45 years are needed. Appropriate ethical identification and management of cases in this population is needed, as is discussion on issues of decarceration and medical release. Re-conceptualisation of incarcerated adults as “citizens in need of care”, rather than as “offenders to be secured”, will be beneficial. Robust, local evidence is needed to assist decision-making.

Originality/value

This is a comprehensive, focused review of relevant evidence, policies and practices for a growing subpopulation of prisoners worldwide with complex needs and particular vulnerability to the COVID-19.

Details

International Journal of Prisoner Health, vol. 17 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

Article
Publication date: 1 February 2003

Steven Simoens and Anthony Scott

In the absence of central guidance on the development of integrated primary care organisations, a diversity of models is emerging. This paper examines the management arrangements…

988

Abstract

In the absence of central guidance on the development of integrated primary care organisations, a diversity of models is emerging. This paper examines the management arrangements of Scottish local health care co‐operatives (LHCCs). A postal questionnaire survey of all 79 LHCCs was conducted. The response rate was 35 per cent. LHCCs set up management bodies and created workgroups. Stakeholder representation was not socially inclusive: attempts to engage patients and local communities were limited and need to be stepped up to increase responsiveness and accountability to local health care users. LHCCs were also vehicles for local ownership and control of health care provision. To facilitate co‐operation among participating practices, LHCCs need to focus on issues of leadership, organisation, and involvement in decision making. Finally, management expenditure per capita was comparable with that of other types of integrated primary care organisations.

Details

Journal of Health Organization and Management, vol. 17 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

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