Population Health Metrics: Improving Community Wellness in Value-Based Payments

Population Health Metrics

Metrics that measure health outcomes shift the focus of policy debate from the inputs and throughputs of national or regional health systems to population-level health. These metrics also provide a baseline against which to compare the performance of health systems across countries.

Articles published in Population Health Metrics are made freely and permanently accessible online immediately after publication, without subscription charges or registration barriers. This is in line with the aims and scope of the journal.

Health Risk Assessment

As global goals for advancing health have become increasingly ambitious, interest in how to measure population health has grown. However, a clear definition of population health and related measures has yet to be available.

The most straightforward approach involves aggregating data on individuals to generate statistics such as the percentage of people suffering from a disease or living in a particular health state. However, this method quickly becomes unwieldy when many problems are being monitored, and comparisons are made between groups or before and after a health intervention. In addition, value based payments incentivize healthcare providers to focus on delivering high-quality care and improved patient outcomes, shifting the emphasis from quantity to the overall value and effectiveness of healthcare services.

Summary measures such as healthy life years and life expectancy have the advantage of reflecting the overall health status of a population. These measures are also easier to communicate and understand by the public than mortality rates.

Smoking Cessation

Smoking has been linked to higher mortality rates, lower quality of life, and a wide range of medical problems, including coronary heart disease, chronic obstructive pulmonary disorder (COPD), and 12 types of cancer.

It also increases the risk of reproductive health problems and adversely affects the health of pregnant women and their fetuses. Health system-level interventions such as integrating tobacco dependence treatment into routine care, requiring pictorial health warnings on cigarette packs, and increasing access to barrier-free smoking cessation insurance coverage can increase the use of proven cessation treatments.

Healthcare professionals can assist patients by asking about and documenting their smoking status at every visit, providing them with clear and personalized advice to quit, and evaluating their readiness to try quitting. Combining behavioral components (such as counseling and nicotine replacement therapy) with pharmacotherapy has been shown to improve quit rates over pharmacotherapy alone.

Physical Activity

Using metrics that provide an accurate and complete picture of population health can help healthcare leaders identify areas for improvement. These metrics should also provide a framework to drive action.

A broad set of indicators can be used to assess the health of a community, including health-related quality of life, social determinants of health, and mortality rates. Many of these indicators can be adjusted for a particular characteristic to give a clearer picture, such as age-adjusted mortality rate, sex-specific mortality, and race-specific death rates.

Indicators are essential for assessing health outcomes but must be interpreted cautiously. This is why Population Health Metrics seeks articles on measuring and valuing health states, come measurements, summary measures of population health, descriptive epidemiology at the population level, burden of disease and risk factor modeling for populations, and approaches for translating from indicators to health-advancing actions.

Nutrition

A large number of population health metrics are available, ranging from simple event counts and rates (mortality, incidence rates for specific diseases) to complex measures of multidimensional phenomena such as physical activity levels (types, durations, intensity), self-reported data, and quite difficult summary measures of population-level health or inequality (health-adjusted life expectancy and like indexes summarizing health inequality).

Many of these indicators can be helpful but need to be meaningful, understandable by those who use them, measurable over time, and sensitive to changes that impact them. They must also be easily incorporated into existing healthcare and public health measurement systems and accessible with relevant and reliable data sources. The development of new health outcome metrics must aim to overcome the limitations of current metrics and provide more comprehensive views of community and population health and wellbeing.

Mental Health

As research shows, mental health is a critical factor in overall wellness. In addition to affecting the self-perceived quality of life, it can also impact other aspects of community well-being like employment, housing, and family and interpersonal relationships.

Mental health is a significant population health metric to measure and improve. Several studies have demonstrated the effectiveness of a variety of treatment options for mental disorders, and many of these treatments are affordable and accessible.

The most common metrics for measuring population health include cause-specific mortality rates, life expectancy at birth, and self-perceived health. Other indicators, such as the Centers for Disease Control and Prevention’s “healthy days” measures, allow communities to track how residents perceive their physical and mental health over time.

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