Scoping of models to support population-based regional health planning and management: comparison with the regional operating model in Victoria, AustraliaJean-Frederic Levesque A F , John J. M. O’Dowd B , Éidín M. Ní Shé C , Jan-Willem Weenink D and Jane Gunn E
A Centre for Primary Health Care and Equity, Level 3, AGSM Building, University of New South Wales Australia, Sydney, NSW 2052, Australia and Bureau of Health Information, Chatswood, 2067, NSW, Australia.
B University of Glasgow, Greater Glasgow and Clyde NHS Board, Public Health, West House, Gartnavel Royal Campus, 1055 Great Wester Road, Glasgow, Scotland, UK, G12 0XH. Email: firstname.lastname@example.org
C UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Belfield, Dublin 4, Ireland. Email: email@example.com
D Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Geert Grooteplein 21, 6525 EZ Nijmegen, The Netherlands. Email: Jan-Willem.Weenink@radboudumc.nl
E Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia. Email: firstname.lastname@example.org
F Corresponding author. Email: JeanFrederic.Levesque@health.nsw.gov.au
Australian Health Review - https://doi.org/10.1071/AH15198
Submitted: 20 October 2015 Accepted: 26 April 2016 Published online: 2 June 2016
Objective The aim of the present study was to try to understand the breadth and comprehensiveness of a regional operating model (ROM) developed within the Victorian Department of Health’s North West Metropolitan Region office in Melbourne, Australia.
Methods A published literature search was conducted, with additional website scanning, snowballing technique and expert consultation, to identify existing operating models. An analytical grid was developed covering 16 components to evaluate the models and assess the exhaustiveness of the ROM.
Results From the 34 documents scoped, 10 models were identified to act as a direct comparator to the ROM. These concerned models from Australia (n = 5) and other comparable countries (Canada, UK). The ROM was among the most exhaustive models, covering 13 of 16 components. It was one of the few models that included intersectoral actions and levers of influence. However, some models identified more precisely the planning tools, prioritisation criteria and steps, and the allocation mechanisms.
Conclusions The review finds that the ROM appears to provide a wide coverage of aspects of planning and integrates into a single model some of the distinctive elements of the other models scoped.
What is known about the topic? Various jurisdictions are moving towards a population-based approach to manage public services with regard to the provision of individual medical and social care. Various models have been proposed to guide the planning of services from a population health perspective.
What does this paper add? This paper assesses the coverage of attributes of operating models supporting a population health planning approach to the management of services at the regional or local level. It provides a scoping of current models proposed to organise activities to ensure an integrated approach to the provision of services and compares the scoped models to a model recently implemented in Victoria, Australia.
What are the implications for practitioners? This paper highlights the relative paucity of operating models describing in concrete terms how to manage medical and social services from a population perspective and encourages organisations that are accountable for securing population health to clearly articulate their own operating model. It outlines strengths and potential gaps in current models.
Additional keywords: population health approach.
References Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet 2009; 374 1196–208.
| Ageing populations: the challenges ahead.CrossRef | 19801098PubMed |
 Productivity Commission. Economic implications of an ageing Australia. Canberra: Productivity Commission; 2005.
 Hasse S, Austin MJ. Service integration: something old and something new. Adm Soc Work 1997; 21 9–29.
| Service integration: something old and something new.CrossRef |
 Armitage GD, Suter E, Oelke ND, Adair CE. Health systems integration: state of the evidence. Int J Integr Care 2009; 9 e82
| Health systems integration: state of the evidence.CrossRef | 19590762PubMed |
 Commonwealth of Australia. Strategic review of health and medical research in Australia – better health through research. Canberra: Australian Government, Department of Health and Ageing; 2013.
 Wilkinson RG, Pickett K. The spirit level – why more equal societies almost always do better. London: Allen Lane; 2009.
 Breton M, Denis JL, Lamothe L. Incorporating public health more closely into local governance of health care delivery: lessons from the Quebec experience. Can J Public Health 2010; 101 314–7.
| 21033545PubMed |
 Commonwealth of Australia. Building a 21st century primary health care system: Australia’s first National Primary Health Care Strategy. Canberra: Australian Government, Department of Health and Ageing; 2009.
 Commonwealth of Australia. Guidelines for the establishment and initial operation of Medicare Locals & information for applicants wishing to apply for funding to establish a Medicare Local. Canberra: Australian Government, Department of Health and Ageing; 2011.
 Stiglitz JE. The price of inequality: how today’s divided society endangers our future. New York: W. W. Norton & Company; 2012.
 O’Shea É, Palmer V. New primary healthcare organisations: recognising opportunities to transition to transformative healthcare organisations? J Organ Transform Soc Chang 2014; 11 125–40.
| New primary healthcare organisations: recognising opportunities to transition to transformative healthcare organisations?CrossRef |
 Hutchison B, Levesque JF, Strumpf E, Coyle N. Primary health care in Canada: systems in motion. Milbank Q 2011; 89 256–88.
| Primary health care in Canada: systems in motion.CrossRef | 21676023PubMed |
 Keleher H. Population health planning for health equity. Aust J Primary Health 2011; 17 327–33.
| Population health planning for health equity.CrossRef |
 Levesque JF, Pineault R, Hamel M, Roberge D, Kapetanakis C, Simard B, Prud Homme A. Emerging organisational models of primary healthcare and unmet needs for care: insights from a population-based survey in Quebec province. BMC Fam Pract 2012; 13 66
| Emerging organisational models of primary healthcare and unmet needs for care: insights from a population-based survey in Quebec province.CrossRef | 22748060PubMed |
 Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: World Health Organization; 2008.
 Keleher H. Planning for population health in Australia’s health reforms. Aust N Z J Public Health 2011; 35 106–7.
| Planning for population health in Australia’s health reforms.CrossRef | 21463402PubMed |
 Robinson A. At the interface of health and community care: developing linkages between aged care services in a rural context. Aust J Rural Health 1999; 7 172–80.
| At the interface of health and community care: developing linkages between aged care services in a rural context.CrossRef | 1:STN:280:DC%2BD3c3gvFyiuw%3D%3D&md5=b774d423c34f146f193ed270571d1e28CAS | 10745732PubMed |
 Barr VJ, Robinson S, Marin-Link B, Underhill L, Dotts A, Ravensdale D, Salivaras S. The expanded Chronic Care Model: an integration of concepts and strategies from population health promotion and the Chronic Care Model. Hosp Q 2003; 7 73–82.
| 14674182PubMed |
 Eliasoph H, Monaghan B, Beaudoin R, Cushman R, DuBois-Wing G, Emery MJ, Fenn WM, Hanmer SJ, Huras P, Lowi-Young M, Mandy P, Trimnell J, Switzer G, Woolgar T, Butler J. ‘We are all in this together’: integrated health service plans in Ontario. Healthc Q 2007; 10 82–7.
| ‘We are all in this together’: integrated health service plans in Ontario.CrossRef | 18271108PubMed |
 Ronson J. Integrated health services plans: from planning to action. Healthc Q 2007; 10 89–90.
| Integrated health services plans: from planning to action.CrossRef | 18271110PubMed |
 Roy DA, Litvak E, Paccaud F. Implementing comprehensive population-accountable health networks in Quebec. Healthc Manage Forum 2014; 27 128–31.
| Implementing comprehensive population-accountable health networks in Quebec.CrossRef | 25518147PubMed |
 DeVore S, Champion RW. Driving population health through accountable care organizations. Health Aff 2011; 30 41–50.
| Driving population health through accountable care organizations.CrossRef |
 Shortell SM, Wu FM, Lewis VA, Colla CH, Fisher ES. A taxonomy of accountable care organizations for policy and practice. Health Serv Res 2014; 49 1883–99.
| A taxonomy of accountable care organizations for policy and practice.CrossRef | 25251146PubMed |
 NHS England. Developing a more collaborative approach to the commissioning of specialised services: Guidance document. 4 March 2015. Available at: https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/03/spec-serv-collabrtv-comms-guid.pdf [verified 9 May 2015].
 Fisher ES, Shortell SM. Accountable care organizations accountable for what, to whom, and how. JAMA 2010; 304 1715–6.
| Accountable care organizations accountable for what, to whom, and how.CrossRef | 1:CAS:528:DC%2BC3cXhtlarurzF&md5=d477b2bcd8e5a622d1b148d5de808215CAS | 20959584PubMed |
 Penn CL. Medical homes, ACOs and population management. J Ark Med Soc 2012; 109 11
| 22866475PubMed |
 Lewis VA, Colla CH, Schpero WL, Shortell SM, Fisher ES. ACO contracting with private and public payers: a baseline comparative analysis. Am J Manag Care 2014; 20 1008–14.
| 25526389PubMed |
 Lévesque JF, O’Dowd J, Rae J. ROM: methodological report. Melbourne: The University of Melbourne and Department of Health North West Metropolitan Region Victoria; 2012.
 Mitchell SM, Shortell SM. The governance and management of effective community health partnerships: a typology for research, policy, and practice. Milbank Q 2000; 78 241–89.
| The governance and management of effective community health partnerships: a typology for research, policy, and practice.CrossRef | 1:STN:280:DC%2BD3cvhsVOisA%3D%3D&md5=8c5d18446c65f5836e45f1a617f2834aCAS | 10934994PubMed |
 Shortell SM, Bazzoli GJ, Dubbs NL, Kralovec P. Classifying health networks and systems: managerial and policy implications. Health Care Manage Rev 2000; 25 9–17.
| Classifying health networks and systems: managerial and policy implications.CrossRef | 1:STN:280:DC%2BD3crhsVOjtQ%3D%3D&md5=558c478bea9b1278e4a6ab8325f3cb7fCAS | 11072628PubMed |
 Mays GP, McHugh MC, Shim K, Perry N, Halverson PK, Lenaway D, Moonesinge R. Identifying dimensions of performance in local public health systems: results from the National Public Health Performance Standards Program. J Public Health Manag Pract 2004; 10 193–203.
| Identifying dimensions of performance in local public health systems: results from the National Public Health Performance Standards Program.CrossRef | 15253515PubMed |
 Fisher ES, Shortell SM, Kreindler SA, Van Citters AD, Larson BK. A framework for evaluating the formation, implementation, and performance of accountable care organizations. Health Aff 2012; 31 2368–78.
| A framework for evaluating the formation, implementation, and performance of accountable care organizations.CrossRef |
 Riley W, Lownik B, Halverson P, Parrotta C, Godsall JR, Gyllstrom E, Gearin KJ, Mays G. Developing a taxonomy for the science of improvement in public health. J Public Health Manag Pract 2012; 18 506–14.
| Developing a taxonomy for the science of improvement in public health.CrossRef | 23023274PubMed |
 Department of Health, South Australia. SA Health public health directorate strategic plan 2008–2010. Adelaide: South Australian Department of Health; 2008.
 Department of Health. Prevention community model: standards and guidelines. Melbourne: Prevention and Population Health Branch, Victorian Government, Department of Health; 2011.
 Queensland Health. Queensland Health population health plan 2007–2012. Brisbane: Queensland Health; 2007.
 National Public Health Partnership. A planning framework for public health practice. Melbourne: National Public Health Partnership; 2000.
 New South Wales Health. Area healthcare services plans – NSW Health guide for development. Sydney: Department of Health New South Wales; 2005.
 Department of Health. Supporting people with long term conditions: An NHS and social care model to support local innovation and integration. Leeds: Long Term Conditions Team; 2004.
 Association of Greater Manchester Authorities (AGMA). The Manchester City Region total place report. Manchester: AGMA; 2010.
 Department of Health. Public Health England’s operating model. Factsheets. 2011. Available at: www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_131892.pdf [verified 9 May 2016].
 Greater Glasgow NHS and Clyde. NHS Greater Glasgow and Clyde strategic planning frameworks 2010–13 discussion paper. Glasgow: National Health Service Greater Glasgow and Clyde; 2012.
 Breton M, Lévesque JF, Pineault R, Lamothe L, Denis JE. Integrating public health into local healthcare governance in Quebec: challenges in combining population and organization perspectives. Healthc Policy 2009; 4 e1590–e78.
 Halverson PK, Mays GP, Kaluzny AD, Richards TB. Not-so-strange bedfellows: models of interaction between managed care plans and public health agencies. Milbank Q 1997; 75 113–38.
| Not-so-strange bedfellows: models of interaction between managed care plans and public health agencies.CrossRef | 1:STN:280:DyaK2s3hslarsw%3D%3D&md5=3abecfb13f75856b67d9b221973649feCAS | 9063302PubMed |
 Shortell SM, Selberg J. Working differently. The IOM’s call to action. Healthc Exec 2002; 17 6–10.
| 11822250PubMed |
 Sheaff R, Benson L, Farbus L, Schofield J, Mannion R, Reeves D. Network resilience in the face of health system reform. Soc Sci Med 1982; 2010 779–86.
 Springgate BF, Brook RH. Accountable care organizations and community empowerment. JAMA 2011; 305 1800–1.
| Accountable care organizations and community empowerment.CrossRef | 1:CAS:528:DC%2BC3MXlslOntLk%3D&md5=c8bd7938eba50fdfb4100401670c35c1CAS | 21505120PubMed |
 Neudorf C. Integrating a population health approach into healthcare service delivery and decision making. Healthc Manage Forum 2012; 25 155–9.
| Integrating a population health approach into healthcare service delivery and decision making.CrossRef | 23252332PubMed |
 Frankish CJ, Moulton GE, Quantz D, Carson AJ, Casebeer AL, Eyles JD, Labonte R, Evoy BE. Addressing the non-medical determinants of health: a survey of Canada’s health regions. Can J Public Health 2007; 98 41–7.
| 17278677PubMed |
 Kindig DA, Isham G. Population health improvement: a community health business model that engages partners in all sectors. Front Health Serv Manage 2014; 30 3–20.
| 25671991PubMed |