Louisville Medicine Volume 63, Issue 11 | Page 15

POPULATION HEALTH: ONE PATIENT AT A TIME Tom James, MD E very few years there seems to be a new buzzword in health care. We have seen HMOs, PPO, IPAs, Medical Home and Accountable Care Organizations all written about extensively. Now Population Health is being touted. Physicians can become jaded with the terminologies and the phrases. Some physicians find no change with the march of each new term as it hits the health care landscape. But, over time, we have all felt the impact. Surely, each of the new movements has brought about changes to the doctor-patient relationship and to reimbursement for services even as they have allowed more citizens access to medical care services. So what is Population Health as it is being used today, and what can we expect to be the result of this new movement in health care? Physicians are used to the practice of medicine as it applies to individual patients while thinking about public health being government-run programs to ensure safety in restaurants, mass immunizations and sanitation programs. But Population Health as a term is more recent. It wasn’t until 2003 that the term was first used in public health literature. Drs. Greg Stottart and David Kindig first proposed the term, defining it as “The aggregate health outcome of health-adjusted life expectancy (quantity and quality) of a group of individuals, in an economic framework that balances the relative marginal returns from the multiple determinants of health.” (Am J Public Health. 2003 March; 93(3): 380–383) This definition has an academic ring to it, so the application of this definition \