Population Health Management (Definitions and Origin)

Definitions

The issue of defining population health is one that has garnered lots and lots of input. There have been many definitions of Population Health Management over the years and each definition does have its importance. Below are some of them

“Populations health management is the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals.”

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“Population Health Management is the aggregation of patient data across multiple health information technology resources, the analysis of that data into a single, actionable patient record, and the actions through which care providers can improve both clinical and financial outcomes.”

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“[Population Health Management] is the health outcomes of a group of individuals, including the distribution of such outcomes within the group.”

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“Population Health Management is the common focus on trying to understand the determinants of health of populations.”

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“Population Health Management is the aggregate health outcome of health-adjusted life expectancy (quantity and quality) of a group of individuals, in an economic framework that balances the relative marginal returns from the multiple determinants of health.”

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The first definition of populations health management gives the healthcare industry a model to use when moving forward with population health management efforts—the public health system and the second definition uses the model of big data and data analytics to tackle populations health management efforts.  The last definition includes the specific measure of population health (health-adjusted life expectancy) as well as consideration of the relative cost-effectiveness of resource allocation to multiple determinants.

But population health management has not always been common, it’s actually a quite recent term. It is a lot more popular now and more widely used than it was in the early 2000s. It was initially used only in policy discussions, research and proposals for new academic departments and institutes. But it continued to grow in use and spread more prominently in the Triple Aim and in clinical settings, has resulted in a conflicting understanding of the term today.

The term has continued to evolve hence the presence of multiple definitions which are actually needed. While the traditional definition of populations health still refers to the management of geographic populations, the new definitions for populations health management and populations medicine are useful in describing activities limited to clinical populations and a narrower set of healthcare outcome determinants.

Origins

There have been many contributions to population health management and even more in recent years. Arguably, one of the most influential contributions in contemporary times to how we understand population health is a book by Evans, Barer, and Marmor published in 1994. In the book, there’s no direct definition of the term populations health management but the concept was described as “the common focus on trying to understand the determinants of health of populations.”

There are definitions of populations health that emphasize the presence of investment tradeoffs, which required “an economic framework that balances the relative marginal returns from the multiple determinants of health.” While less appreciated as a hallmark of population health thinking, the economic tradeoffs are equally important. A critical component of population health policy has to be how the most health return can be produced from the next dollar invested, such as expanding insurance coverage or reducing smoking rates or increasing early childhood education. This is important for clinical populations as emphasized by the Triple Aim, but also for geographic populations needing resources from both public and private sectors. If resources were unlimited we wouldn’t have to make investment choices or trade-offs. However even if economic resources are unlimited, there would still be a limit of time, manpower etc so a trade-off is inevitable except we live in a world of ceteris paribus.