What is Population-based Healthcare?
Population healthcare focuses primarily on populations defined by a common need which may be a symptom such as breathlessness, a condition such as arthritis or a common characteristic such as frailty in old age, not on institutions, or specialties or technologies. Its aim is to maximise value and equity for those populations and the individuals within them.
This Glossary is about Population and Personalised Care the latter being a style of clinical and general management which always considers the patients’ perspective as the most important and is committed to increasing patient Engagement, Empowerment or Involvement, which may be regarded as synonyms. Personalised care is an element of patient centred care and is the other side of the coin from population care. This is a diffuse and fast moving field with language evolving at a rapid rate. Here are the key terms and concepts.
Technical Value in Healthcare: determined by how well resources are used within services for each individual and the whole population .
Allocative Value in Healthcare: determined by how assets are allocated to services for different purposes.
The term personalisation is used increasingly and, as a consequence, has developed an increasing number of meanings.
One of the earliest uses was in the definition of Evidence Based Medicine. Although accused of being cook book medicine, the origination of Evidence Based Medicine emphasised the need to relate the evidence to the unique clinical condition to the individual patient and his/her values:
Tremendous progress has been made over the last forty years due to the second healthcare revolution, with the first healthcare revolution having been the public health revolution of the nineteenth century. Hip replacement, transplantation, and chemotherapy are examples of the high tech revolution funded by increased investment and, in the last twenty years, optimised by improvements in quality, safety and evidence based decision making. However there are still three outstanding problems which are found in every health service no matter how they are structured and funded: One of these problems is huge and unwarranted variation in access, quality, cost and outcome, and an analysis of unwarranted variation reveals the other two Overuse, which leads to waste, that is anything that does not add value to the outcome for patients or uses resources that could give greater value if used for another group of patients and often, patient harm, even when the quality of care is high
Underuse which leads to failure to prevent the diseases that healthcare can prevent, stroke and vascular dementia in atrial fibrillation for example, and often inequity
We have different resources for different needs, which can help drive improvements organisationally, individually or both.
Clinical advances of the last fifty years have led to dramatic increases in life expectancy and years of life free from disability. However, every health service still faces five outstanding problems and four new challenges that are interlinked
In England alone there are about two thousand surgeons in management and leadership positions in addition many young surgeons see the need to develop understanding of management and leadership to prepare them for the health service or academic jobs.
One source of evidence is that the people who walk say that walking makes them feel, and look, good. But this does not prove that walking is beneficial or, as is said when new medical treatments are evaluated, that it does more good than harm. It might be that people who feel good about themselves and who are healthy, walk more than people who are depressed or unwell, and there is probably some truth in that