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

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

Douglas J Noble  1 , Trisha Greenhalgh, Lawrence P Casalino
Affiliations

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

Douglas J Noble et al. BMJ Open. .

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.

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References

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    1. Patient Protection and Affordable Care Act, 2010. http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf (accessed 11 Apr 2014).

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