Population Health

What is Population Health?

Population HealthPopulation health has become a very popular term in recent years and has been used interchangeably with Public Health, although the two are quite different.  Population health refers to the health outcomes for a population or group of individuals, including the distribution of such outcomes within the group. Public health is the act of improving health through health improvement, prevention of disease and improving quality of services. Public health specialists and academics have been involved in the applications of population health.  This is true of the UK where there is a growing emphasis on improving health outcomes for patients and people rather than on outputs or targets (see the Public Health Outcomes Framework).

According to Wikipaedia, the concept of Population Health is to complement the classic efforts of public health agencies by addressing a broader range of factors shown to impact the health of different populations. In particular, there is a focus on the social determinants of health, i.e. social, environmental, cultural and physical factors that impact upon the health of human populations.  By reducing the impact of these factors, you can reduce the health inequities and inequalities among different population groups.  It is  much more of a sociological approach rather than starting with the variations between groups and working backwards to determine the causes or reasons for the disparities.  

Arguably, population health is a broad concept but its value lies in its focus on the distribution of health (i.e. health will vary between and within populations) and the facilitation of knowledge across the many factors that influence health outcomes. This could enable different policy and decision makers to find a common language or interest in which to work together.  

Uses of Population Health

On a GP practice level, I have heard conversations around helping GP practices to utilise a population approach to the planning and running of their services.  This effectively means helping them to think beyond the day-to-day management onto understanding who their population is, the variation in health conditions across the population and the patient outcomes they want to achieve.  

Population Health Management (PHM) is a method used to improve morbidity patterns and is being encouraged to be used by hospitals to better manage their patient flow.  This method places an emphasis on patient outcomes and quality of service, shifting hospitals from traditional reimbursement based on volume of procedures to improving patient experience fo care, reducing costs and focusing on keeping people well in the community.  This has led to the investment in telemedicine, community-based (urgent care) clinics in areas with high proportion of residents using the emergency department as primary care, and patient care coordinator roles to coordinate healthcare services across the system. As in the USA, the UK are gearing up to deliver accountable care organisations (ACOs).   These are value-based reimbursement models with population health as a main driver.  Within the ACO model, hospitals have to meet specific quality benchmarks, focus on prevention, and carefully manage patients with chronic diseases. Providers will be encouraged to keep their patients healthy and out of the hospital. The intention is that inpatient admission and emergancy department rates will drop.