Abstract
BackgroundA population-based approach to healthcare goes beyond the traditional biomedical model and addresses the importance of cross-sectoral collaboration in promoting health of communities. By establishing partnerships across primary care (PC) and public health (PH) sectors in particular, healthcare organizations can address local health needs of populations and improve health outcomes. The purpose of this study was to map a series of interventions from the empirical literature that facilitate PC-PH collaboration and develop a resource for healthcare organizations to self-evaluate their clinical practices and identify opportunities for collaboration with PH.MethodsA scoping review was designed and studies from relevant peer-reviewed literature and reports between 1990 and 2017 were included if they met the following criteria: empirical study methodology (quantitative, qualitative, or mixed methods), based in US, Canada, Western Europe, Australia or New Zealand, describing an intervention involving PC-PH collaboration, and reporting on structures, processes, outcomes or markers of a PC-PH collaboration intervention.ResultsOut of 2962 reviewed articles, 45 studies with interventions leading to collaboration were classified into the following four synergy groups developed by Lasker’s Committee on Medicine and Public Health: Coordinating healthcare services (n = 13); Applying a population perspective to clinical practice (n = 21); Identifying and addressing community health problems (n = 19), and Strengthening health promotion and health protection (n = 21). Furthermore, select empirical examples of interventions and their key features were highlighted to illustrate various approaches to implementing collaboration interventions in the field.ConclusionsThe findings of our review can be utilized by a range of organizations in healthcare settings across the included countries. Furthermore, we developed a self-evaluation tool that can serve as a resource for clinical practices to identify opportunities for cross-sectoral collaboration and develop a range of interventions to address unmet health needs in communities; however, the generalizability of the findings depends on the evaluations conducted in individual studies in our review.From a health equity perspective, our findings also highlight interventions from the empirical literature that address inequities in care by targeting underserved, high-risk populations groups. Further research is needed to develop outcome measures for successful collaboration and determine which interventions are sustainable in the long term.
Highlights
A population-based approach to healthcare goes beyond the traditional biomedical model and addresses the importance of cross-sectoral collaboration in promoting health of communities
Of the 2962 studies identified by the search strategy, 45 met our inclusion criteria and were selected for the final analysis, as illustrated in a PRISMA flowchart outlining the search and screening process involved in selection of articles for the scoping review (Fig. 1)
Our scoping review maps a series of specific interventions implemented by healthcare organizations internationally that facilitated collaboration between clinical care and public health (PH)
Summary
A population-based approach to healthcare goes beyond the traditional biomedical model and addresses the importance of cross-sectoral collaboration in promoting health of communities. Healthcare systems around the world are facing persistent pressures that result in poor performance and growing inequities in care [3] These include a rising burden of illness attributable to major chronic diseases, as well as increasing costs and complexity of healthcare delivery [4, 5]. To address these growing pressures and achieve a shift from our traditional biomedical model of healthcare to one that prioritizes wellness of populations [6], various authors have highlighted cross-sectoral collaboration as a key feature of the population health approach [7,8,9,10]. In their report on PC and PH integration, the IOM point out that pressing health needs within populations such as management of non-communicable diseases, maternal and child health, and cancer prevention fall within the scope of both PC and PH, yet these sectors are largely functioning independently of each other
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