Improving population health one person at a time? Accountable care organisations: perceptions of population health--a qualitative interview study

BMJ Open. 2014 Apr 25;4(4):e004665. doi: 10.1136/bmjopen-2013-004665.

Abstract

Objective: This qualitative interview study explored perceptions of the phrases 'population health', 'public health' and 'community health'.

Setting: Accountable care organisations (ACOs), and public health or similar agencies in different parts of the USA.

Participants: Purposive sample of 29 interviewees at four ACOs, and 10 interviewees at six public health or similar agencies.

Results: Interviewees working for ACOs most often viewed 'population health' as referring to a defined group of their organisation'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.

Conclusions: Conflating geographical population health with the health of ACOs' patients may divert attention and resources away from organisations that use non-medical means to improve the health of geographical populations. As ACOs battle to control costs of their population of patients, 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.

Keywords: Accountable Care Organizations; Affordable Care Act; Community Health; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; PUBLIC HEALTH; Population Health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accountable Care Organizations*
  • Attitude of Health Personnel*
  • Humans
  • Interviews as Topic
  • Public Health*
  • Qualitative Research