News and Highlights

May 2014

Improving Population Health One Person at a Time?

Dr. Douglas Noble

Douglas Noble, MD, MPH, currently a Regional Health Advisor at UNICEF and previously a Commonwealth Fund Harkness Fellow in Health Care Policy and Practice in the Department, and Lawrence Casalino, MD, PhD, Professor of Healthcare Research and Policy and Chief of the Division of Healthcare Policy and Economics, are the lead and senior authors, respectively, of an article published April 25, 2014, in the British Medical Journal (BMJ) titled "Improving population health one person at a time? Accountable care organisations: perceptions of population health—a qualitative interview study."

Dr. Lawrence Casalino

The authors conducted a qualitative interview study to explore perceptions of the phrases “population health,” “public health” and “community health” in accountable care organizations (ACOs) and public health or similar agencies in different parts of the USA. They found that interviewees working for ACOs most often viewed “population health” as referring to a defined group of their organization’s patients, though a few applied the phrase to people living in a geographical area. In contrast, interviewees working for public health agencies were more likely to consider ‘population health’ from a geographical perspective. Dr. Noble, Dr. Casalino, and co-author Trisha Greenhalgh, MD, of Barts and The London School of Medicine and Dentistry in London, UK, conclude that conflating geographical population health with the health of ACOs’ patients may divert attention and resources away from organizations that use non-medical means to improve the health of geographical populations. “As ACOs battle to control costs of their population of patients,” they suggest, “it would be more accurate to consider using a more specific phrase, such as ‘population of attributed patients’, to refer to ACOs’ efforts to care for the health of their defined group of patients.” The study was covered in a Weill Cornell Medical College news release and received publicity in HealthCanal and Becker's Hospital Review.


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