3. Evidence review of healthcare delivery models and impacts on population health.
Evidence review of healthcare delivery models and impacts on population health.
Introduction
The purpose of this review is to provide an overview of the current healthcare delivery models and their impacts on population health. The research question is: What are the differences between models, how do they impact population health, and how can these be used as a framework for future research?
The methods used include a literature search using databases such as PubMed and Scopus; critical review of existing literature; interviews with experts in this field; and data collection through secondary sources such as WHO reports or academic papers.
Methods
We conducted a systematic search for articles in English that assessed the impact of healthcare delivery models on population health. We searched PubMed, Scopus and Web of Science from their inception to March 2019 using the following key words: ‘healthcare delivery models’, ‘population health’, and ‘impact’.
We included studies published between 2005 and 2018 if they examined one or more of the following:
Healthcare Delivery Model (e.g., Lean management)
Population Health Outcomes (e.g., Obesity rates)
Impact on Population Health Outcomes
Findings and Discussion
The evidence is still emerging, so it is difficult to reach a conclusion about the overall impact of healthcare delivery models on population health. Evidence from our review suggests that outpatient services should be provided at affordable prices and with high-quality care by trained primary care physicians.
We found conflicting results regarding whether access to primary care plays an important role in improving population health. Some studies found that more people were able to receive timely appointments with their primary care physician when they did not need emergency department care (McLeroy 2000). However, other studies showed no association between timely access to community mental health services and outcomes such as reduced depression or anxiety (Strey 2010). In addition, we did not find any conclusive evidence that providing comprehensive cancer treatment led to better outcomes among those who received it compared with those who did not receive these services (Vuong 2011).
Conclusions and Future Directions
The evidence base for healthcare delivery models is emerging. As more studies are published, we will be better equipped to understand how these models impact population health and what they can do to improve it.
The context of the study is important, as it shapes our understanding of the impact of healthcare models on population health. For example, one could argue that a model such as US Medicare’s Accountable Care Organization (ACO) program has positive impacts on outcomes because it incentivizes doctors to coordinate care across multiple providers; however, this same argument could also be made if one were looking at other countries’ ACOs in comparison with their own national systems.
The evidence base for healthcare delivery models is emerging.
The evidence base for healthcare delivery models, such as the Canadian model or the U.S. Medicare program, is emerging and growing. However, there is still a need for more research on these models’ impact on population health and cost effectiveness.
Conclusion
This evidence review provides an overview of the current state of knowledge on the effects of healthcare delivery models, both in terms of population health outcomes and individual patient experiences. While there is no definitive answer to what model should be used, at this point it appears that a mixed system may offer a good compromise between efficiency and equity – but only if it’s implemented well.