Population Health Management

The healthcare sector in the Netherlands faces a number of major challenges. The number of people with chronic diseases is increasing, and care costs continue to rise. At Health Campus The Hague, we develop solutions for a patient-oriented, affordable, and inclusive healthcare system. This can be distilled into one powerful term: Population Health Management.

Population Health Management is a fairly new and interdisciplinary field that focusses on sustainable healthcare and a proactive, more prevention-oriented health policy. It involves a team of doctors, data scientists, administrators, and social scientists coming together to work to improve human health and reduce discrepancies in health outcomes by analysing the information registered in routine care. It is an entirely new approach that results in care that better answers to what people need to stay or become healthy, as we are moving from disease management to health management.

From data to solutions

No two patient populations are the same. One person who knows all about that is Mattijs Numans, Professor of General Practice, head of the LUMC Department Public Health and Primary Care, and (since 2016) director of the Health Campus (then called LUMC Campus) The Hague. ‘Population Health Management starts with mapping out the biggest health problems and risks in a city, community, primary care practice population, hospital ward, or street. To do this, we use a wide variety of data, such as data from general practitioners, local hospitals, the social domain, and Municipal Health Services (GGD’en). Once we get a clear picture, we are able to come up with focussed, usable solutions that we can then evaluate for their effectiveness.’

Prevention

With its theme of Population Health Management, Health Campus The Hague focusses on groups like young people, the vulnerable elderly, people with unexplained physical symptoms, and people in disadvantaged situations due to multiple causes, or people with a complex multimorbid context. ‘We don’t want to just cure, we also want to prevent,’ says Numans. ‘That’s why we develop interventions: targeted solutions for specific (sub-)groups that potentially benefit most. Take the example of obesity and “food security” in children; in some parts of The Hague, many children are overweight. But in those same neighbourhoods, there are also a high number of children with food insecurity – that means, more or less, that they regularly can’t count on getting a normal meal at mealtime. By combining data about this from schools and childcare facilities with data from the local health care services, we gained tremendous insight into this problem. For example, we see that many children have irregularity in their eating schedules, and we can now respond to this.’

More and more often, we are seeing the vulnerable elderly who still live on their own, unexpectedly ending up in urgent care or at the GP out-of-hours surgery; which is a potentially preventable adverse health event.

Mattijs Numans

Vulnerable elderly

‘More and more often, we are seeing the vulnerable elderly who still live on their own, unexpectedly ending up in urgent care or at the GP out-of-hours surgery,’ Numans explains. ‘We consider this as a preferably avoidable adverse health event, that you really would want to prevent from happening. For that, the general practice centres have to have a good overview of the vulnerability status, or the frailty status, of the older patients that they are responsible for. We developed a method that helps general practices prioritise their contacts with elderly people with a periodic frailty assessment. The bottom line is that gives them an earlier picture of the impending health risks at any moment. And that approach is working one way or the other,’ says Numans. ‘Now we, or the practice nurses, outreach to the patients at risk just a little bit earlier, to intervene proactively with tailor made interventions before the problem becomes worse.’

The contrasts of The Hague

Every city, and every community within it, has its own health problems. In The Hague, these regional differences are particularly pronounced. ‘The Hague is a city of great contrasts,’ Numans explains. ‘A kind of pressure cooker with all the big city health issues, and more than anything else, a city made up of people from all different socioeconomic and cultural backgrounds. That makes The Hague extremely interesting to us: the city needs us, but we also need the city of The Hague as a learning and research environment. Solutions that work here can be projected onto other cities and communities.’

Academic in the region

Health Campus The Hague is like a little piece of the Leiden University Medical Centre in The Hague that focusses on the region and the populations outside the hospital. According to Numans, it is important for University Medical Centres to look beyond the walls of their own top referent care medical centre. ‘That gives you a number of big advantages,’ he says. ‘It makes the cooperation with regional care providers, local authorities, and other parties go a lot more smoothly and produces more because the threshold on making contact is lower, while from the academic point of view the students, teachers and researchers are constantly inspired by a lively interdisciplinary medical context. That’s how, when we join forces, we make the best contribution to prevention and community oriented care – both important themes for the future of healthcare.’

Master’s in Population Health Management

The demand for specially trained professionals who can play a connecting role between the various disciplines in Population Health Management is high. Health Campus The Hague has offered a two-year Master’s programme in  since 2021. In the programme, students are trained to be strategic partners who bring relevant persons and organisations together for innovative and preventive solutions in healthcare.