Betty Steenkamer1, Hanneke Drewes2, Kim Putters3,4, Hans van Oers5,6, Caroline Baan5,6. 1. Researcher, Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, the Netherlands. 2. Senior Researcher, Department of Quality of Care and Health Economics, National Institute for Public Health and the Environment (RIVM), the Netherlands. 3. Professor, Erasmus School of Health Policy & Management, Erasmus University, the Netherlands. 4. Director, The Netherlands Institute for Social Research, the Netherlands. 5. Professor, Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, the Netherlands. 6. Chief Science Officer, National Institute for Public Health and the Environment (RIVM), the Netherlands.
Abstract
OBJECTIVE: Population health management (PHM) refers to large-scale transformation efforts by collaborative adaptive health networks that reorganize and integrate services across public health, health care, social care and wider public services in order to improve population health and quality of care while at the same time reducing cost growth. However, a theory-based framework that can guide place-based approaches towards a comprehensive understanding of how and why strategies contribute to the development of PHM is lacking, and this review aims to contribute to closing this gap by identifying the key components considered to be key to successful PHM development. METHODS: We carried out a scoping realist review to identify configurations of strategies (S), their outcomes (O), and the contextual factors (C) and mechanisms (M) that explain how and why these outcomes were achieved. We extracted theories put forward in included studies and that underpinned the formulated strategy-context-mechanism-outcome (SCMO) configurations. Iterative axial coding of the SCMOs and the theories that underpin these configurations revealed PHM themes. RESULTS: Forty-one studies were included. Eight components were identified: social forces, resources, finance, relations, regulations, market, leadership, and accountability. Each component consists of three or more subcomponents, providing insight into (1) the (sub)component-specific strategies that accelerate PHM development, (2) the necessary contextual factors and mechanisms for these strategies to be successful and (3) the extracted theories that underlie the (sub)component-specific SCMO configurations. These theories originate from a wide variety of scientific disciplines. We bring these (sub)components together into what we call the Collabroative Adaptive Health Network (CAHN) framework. CONCLUSIONS: This review presents the strategies that are required for the successful development of PHM. Future research should study the applicability of the CAHN framework in practice to refine and enrich identified relationships and identify PHM guiding principles.
OBJECTIVE: Population health management (PHM) refers to large-scale transformation efforts by collaborative adaptive health networks that reorganize and integrate services across public health, health care, social care and wider public services in order to improve population health and quality of care while at the same time reducing cost growth. However, a theory-based framework that can guide place-based approaches towards a comprehensive understanding of how and why strategies contribute to the development of PHM is lacking, and this review aims to contribute to closing this gap by identifying the key components considered to be key to successful PHM development. METHODS: We carried out a scoping realist review to identify configurations of strategies (S), their outcomes (O), and the contextual factors (C) and mechanisms (M) that explain how and why these outcomes were achieved. We extracted theories put forward in included studies and that underpinned the formulated strategy-context-mechanism-outcome (SCMO) configurations. Iterative axial coding of the SCMOs and the theories that underpin these configurations revealed PHM themes. RESULTS: Forty-one studies were included. Eight components were identified: social forces, resources, finance, relations, regulations, market, leadership, and accountability. Each component consists of three or more subcomponents, providing insight into (1) the (sub)component-specific strategies that accelerate PHM development, (2) the necessary contextual factors and mechanisms for these strategies to be successful and (3) the extracted theories that underlie the (sub)component-specific SCMO configurations. These theories originate from a wide variety of scientific disciplines. We bring these (sub)components together into what we call the Collabroative Adaptive Health Network (CAHN) framework. CONCLUSIONS: This review presents the strategies that are required for the successful development of PHM. Future research should study the applicability of the CAHN framework in practice to refine and enrich identified relationships and identify PHM guiding principles.
Keywords:
guiding principles; population health management; realist evaluation; reorganizing and integrating services; triple aim
Authors: Djoeke van Dale; Lidwien Lemmens; Marieke Hendriksen; Nella Savolainen; Péter Nagy; Edit Marosi; Michela Eigenmann; Ingrid Stegemann; Heather L Rogers Journal: Int J Environ Res Public Health Date: 2020-09-05 Impact factor: 3.390