5 steps to population-based care

5 steps to population-based care

The Dutch healthcare sector is facing a major challenge. Healthcare costs are growing explosively. If we want to continue to provide good and affordable care, we need to reform it. One way to do this is to use the healthcare

One way to do this is to design health care at the population level. We call this population-based care, Community Based Healthcare (CBHC), or population management. To make population-oriented care a success, network formation is essential.

What is population-based care?

Population-oriented care means working on the health of a population that is demarcated on the basis of set criteria, for example people in a neighbourhood with a specific demand for care, such as the group of vulnerable elderly people in Amsterdam South-East. The starting point for population-oriented care is what the demarcated population in question needs in order to remain healthy. It is essential in population-oriented care that care remains tailored to the individual patient.

Why population-based care?

Funding at the population level leads to better care. Healthcare providers receive a fixed amount per patient in the population. How often they make use of care does not play a role in this. As a result, healthcare providers have a greater incentive to organise the care properly for the entire population. This leads to a more efficient use of the available budget. Population-based care is therefore care according to the Triple Aim.

Importance of organisational networks

If we want to properly organize the care of a demarcated population, we need to form networks of organizations. A network can achieve results that none of the individual organizations can. After all, organisations complement each other in terms of knowledge, expertise and specialisations.

Steps towards population-based care

Population-based care cannot be achieved from one moment to the next. To form a good organizational network, organizations must go through a number of steps. I’ll give you these below.

Step 1: Research willingness to change

Organizations have to want to change course, they have to feel a real urgency to develop a common vision and strategy. In practice, this is sometimes difficult. Parties are simply very different, they look at issues from their own perspective.

Step 2: Involve patients

Patient involvement is indispensable for effective prevention and health care. New developments in medical and information technology are making this increasingly possible. Examples are biomarkers or big data. Involve the patient according to the 4P principle:

1. 1. Personal
2. Treaters tailor care to the patient. Not only does his health count, but also his wishes, preferences and personal situation.
3. 2. Predictive
4. Data provided by the patient is combined with each other. With the image that emerges, we can predict health risks in the future.
5. 3. Preventive
6. If we map out the health risks, we can prevent diseases in a timely and effective manner.
7. 4. Participatory
8. The patient is an active party in the care process. He/she is in charge of his/her own health. Healthcare professionals and organizations have a supportive role.

Step 3: Predictive modelling

ICT is indispensable for successful population-oriented care. Using ICT, we can make risk assessment models based on patient data. We call this ‘predictive modelling’. With these predictive tools, we can estimate the likelihood of someone experiencing an unplanned hospital admission or emergency room visit, making it possible to prevent instead of cure.

All this takes place in the following sub-steps:

1. 1. Establishing a uniform objective and definitions.
2. Example of an objective: better perceived health of vulnerable elderly people in Amsterdam Zuid-Oost. Definition: A better perceived health exists if…, by ‘frail elderly’ we mean…
3. 2. Data collection, storage and management.
4. In the example mentioned above we are collecting data on the inhabitants of Amsterdam Zuid-Oost.
5. 3. Risk estimation population.
6. We analyze the data. Are there many vulnerable elderly people in Amsterdam Zuid-Oost? How do they experience their health?
7. 4. Identification of risk groups.
8. Are there vulnerable elderly people in Amsterdam Zuid-Oost who experience significantly more health problems? Single or lonely elderly people, for example?
9. 5. Intervention for high risk groups.
10. An intervention takes place in vulnerable elderly people who experience many health problems. For example, they are monitored more often.
11. 6. Measuring and monitoring outcomes.
12. Did the intervention work? Do the frail elderly experience fewer problems?

Step 4: Form an organisational network

As mentioned earlier, for successful population-oriented care, organisations must work closely together and form a network. This network must have an official legal form in order to be able to fully finance the care. But how can we best achieve this? We can distinguish three types of organizational networks:

1. The self-regulating network

This is the simplest form. This consists of different organizations that work together in a collective manner, but do not have a separate control unit. The network members themselves are the board. This form is least suitable for population-based care.

2. Leader and organization network

In this type of network, members share a common goal and there is collaboration and interaction. One of the members has the function of control unit. This member shall coordinate and participate in the decisions of the network.

3. Network administrative organisation

This is a network with an independent unit responsible for coordinating the network and its activities. This so-called network administration organisation is not itself an active party in the network. The task is to manage the network independently of the other parties. International research has shown that this is the most suitable network form for population-oriented care.

Step 5: Payment for results

The final step is funding. This must take place in the form ofoutcome funding. Healthcare providers and networks receive a fixed amount per inhabitant or insured in their population, whether they use healthcare or not. This stimulates efficient working. After all, a fixed amount for each citizen means that they will have to make as little use of health care as possible. Well-functioning networks of care organisations are indispensable for this.

E-Book care networks that work: The key to better outcomes

Good cooperation is essential for good population-oriented care. To do this, obstacles must be overcome. Read how you can do this in the free e-Book care networks that work.