In acute care settings, the main purpose for applying epidemiological methods is to understand:

  1. Cohen D, Huynh T, Sebold A, Harvey J, Neudorf C, Brown A. The population health approach: a qualitative study of conceptual and operational definitions for leaders in Canadian healthcare. SAGE Open Med. 2014;2:205031211452261.

    Article  Google Scholar 

  2. Szreter S. The population health approach in historical perspective. Am J Public Health. 2003;93(3):421–31.

    PubMed  PubMed Central  Article  Google Scholar 

  3. Frenk J, Chen L, Bhutta Z, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923–58.

    PubMed  Article  Google Scholar 

  4. Institute of Medicine. In: Smolinski MS, Hamburg MA, Lederberg J, editors. Microbial threats to health: emergence, detection, and response. Washington: National Academy Press; 2005.

    Google Scholar 

  5. 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.

    Google Scholar 

  6. Berwick D, Nolan T, Whittington J. The triple aim: care, health, and cost. Health Aff. 2008;27(3):759–69.

    Article  Google Scholar 

  7. Naylor D, Girard F. Unleashing innovation: excellent healthcare for Canada, advisory panel on healthcare innovation; 2015.

    Google Scholar 

  8. Washington A, Coye M, Boulware L. Academic health systems’ third curve. JAMA. 2016;315(5):459.

    CAS  PubMed  Article  Google Scholar 

  9. Etches V, Frank J, Ruggiero E, Manuel D. Measuring population health: a review of indicators. Annu Rev Public Health. 2006;27(1):29–55.

    PubMed  Article  Google Scholar 

  10. Kindig D, Stoddart G. What is population health? Am J Public Health. 2003;93(3):380–3.

    PubMed  PubMed Central  Article  Google Scholar 

  11. Primary care and public health: exploring integration to improve population health. Washington, D.C.: National Academies Press; 2012.

  12. Huynh T, Cohen D. Innovators and early adopters of population health in healthcare: real and present opportunities for healthcare–public health collaboration. HealthcarePapers. 2013;13(3):53–7.

    PubMed  Article  Google Scholar 

  13. Pinto A. Improving collaboration between public health and primary healthcare. HealthcarePapers. 2013;13(3):41–8.

    PubMed  Article  Google Scholar 

  14. Gosling R, Davies S, Hussey J. How integrating primary care and public health could improve population health outcomes: a view from Liverpool, UK. Public Health Res Pract. 2016;26(1):e2611602.

    PubMed  Article  Google Scholar 

  15. Montero J, Terrillion A. Reintegrating health care and public health. J Public Health Manag Pract. 2013;19(5):493–6.

    PubMed  Article  Google Scholar 

  16. Health 2020: the European policy for health and well-being [internet]. Euro.who.int. 2018. Available from: http://www.euro.who.int/__data/assets/pdf_file/0011/199532/Health2020-Long.pdf?ua=1.

  17. Bindman A, Weiner J, Majeed A. Primary care groups in the United Kingdom: quality and accountability. Health Aff. 2001;20(3):132–45.

    CAS  Article  Google Scholar 

  18. Naylor C, Curry N, Holder H, Ross S, Marshall L, Tait E. Clinical commissioning groups: supporting improvement in general practice? London: the King’s fund and Nuffield trust; 2013.

    Google Scholar 

  19. Breton M, Lévesque J, Pineault R, Lamothe L, Denis J. Integrating public health into local healthcare governance in Quebec: challenges in combining population and organizational perspectives. Healthcare Policy | Politiques de Santé. 2009;4(3):e159–78.

    PubMed  PubMed Central  Article  Google Scholar 

  20. Mitton C, Patten S, Waldner H, Donaldson C. Priority setting in health authorities: a novel approach to a historical activity. Soc Sci Med. 2003;57(9):1653–63.

    PubMed  Article  Google Scholar 

  21. Brown A, Upshur R, Sullivan T. Public health and primary care: competition or collaboration. HealthcarePapers. 2013;13(3):4–8.

    PubMed  Article  Google Scholar 

  22. Guyon A, Hancock T, Kirk M, MacDonald M, Neudorf C, Sutcliffe P, et al. The weakening of public health: a threat to population health and health care system sustainability. Can J Public Health. 2017;108(1):1.

    Article  Google Scholar 

  23. Levesque J, Breton M, Senn N, Levesque P, Bergeron P, Roy D. The interaction of public health and primary care: functional roles and organizational models that bridge individual and population perspectives. Public Health Rev. 2013;35(1).

  24. Martin-Misener R, Valaitis R, Wong S, MacDonald M, Meagher-Stewart D, Kaczorowski J, et al. A scoping literature review of collaboration between primary care and public health. Primary Health Care Res Dev. 2012;13(04):327–46.

    Article  Google Scholar 

  25. Designing a system for clinical-community linkages at the individual level. Institute for Healthcare Improvement; 2016.

  26. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8:19–32.

    Article  Google Scholar 

  27. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69–10.

    PubMed  PubMed Central  Article  Google Scholar 

  28. Lasker R, Committee on medicine and public health N, Abramson D. Medicine & Public Health: the power of collaboration [internet]. 2018. Available from: http://publichealth.jbpub.com/turnock/3e/chapterOutline/nyam_monograph1.pdf

  29. Auerbach J, Currier M, Dahl S, Barry A. Public health and primary care collaboration: national, state, and local examples to enhance STD prevention and care services. Sex Transm Dis. 2014;41:S22.

    Google Scholar 

  30. Millar J. A framework for community-oriented primary healthcare. HealthcarePapers. 2012;12(2):41–5.

    PubMed  Article  Google Scholar 

  31. Lebrun L, Shi L, Chowdhury J, Sripipatana A, Zhu J, Sharma R, et al. Primary care and public health activities in select US health centers: documenting successes, barriers, and lessons learned. Am J Public Health. 2012;102(S3):S383–91.

    PubMed  PubMed Central  Article  Google Scholar 

  32. Saeed M. Improving the public health/primary care partnership: a perspective from NHS Hounslow. London J Prim Care. 2012;4(2):100–3.

    Article  Google Scholar 

  33. Leatt P, Pink G, Guerriere M. Towards a Canadian model of integrated healthcare. HealthcarePapers. 2000;1(2):13–35.

    CAS  PubMed  Article  Google Scholar 

  34. Hill A, Levitt C, Chambers W, Cohen M, Underwood J. Primary care and population health promotion. Collaboration between family physicians and public health units in Ontario. Can Fam Physician. 2001;47:15–7 22-5.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Hogg W, Huston P, Martin C, et al. Promoting best practices for control of respiratory infections: collaboration between primary care and public health services. Can Fam Physician. 2006;52(9):1110.

    PubMed  PubMed Central  Google Scholar 

  36. Moloughney B. Public health readiness and role in transformation to a community-based primary healthcare system. HealthcarePapers. 2013;13(3):64–70.

    PubMed  Article  Google Scholar 

  37. Kempe A, Albright K, O'Leary S, Kolasa M, Barnard J, Kile D, et al. Effectiveness of primary care–public health collaborations in the delivery of influenza vaccine: a cluster-randomized pragmatic trial. Prev Med. 2014;69:110–6.

    PubMed  Article  Google Scholar 

  38. Adany R, Kosa K, Sandor J, Papp M, Furjes G. General practitioners' cluster: a model to reorient primary health care to public health services. Eur J Public Health. 2013;23(4):529–30.

    PubMed  Article  Google Scholar 

  39. Hurst K, Ford J, Gleeson C. Evaluating self-managed integrated community teams. J Manag Med. 2002;16(6):463–83.

    PubMed  Article  Google Scholar 

  40. Oros M, Johantgen M, Antol S, Heller B, Ravella P. Community-based nursing centers: challenges and opportunities in implementation and sustainability. Policy Polit Nurs Pract. 2001;2(4):277–87.

    Article  Google Scholar 

  41. Pickens S, Boumbulian P, Anderson R, Ross S, Phillips S. Community-oriented primary Care in Action: a Dallas story. Am J Public Health. 2002;92(11).

    PubMed  PubMed Central  Article  Google Scholar 

  42. Harris K, Pickering L, Fasano N, Fowler G, Gangarosa P, Gust D. Relationships between state health departments and medical professional organizations regarding immunizations. J Public Health Manag Pract. 2007;13(6):590–4.

    PubMed  Article  Google Scholar 

  43. Calman N, Hauser D, Lurio J, Wu W, Pichardo M. Strengthening public health and primary care collaboration through electronic health records. Am J Public Health. 2012;102(11):e13–8.

    PubMed  PubMed Central  Article  Google Scholar 

  44. Griffiths S, Haslam D. Putting public health practice into primary care practice: practical implications of implementing the changes in shifting the balance of power in England. J Public Health. 2002;24(4):243–5.

    Article  Google Scholar 

  45. Perry R, Stephenson C. Improving population health through collaboration and innovation. Popul Health Manag. 2013;16(S1):S–34-S-37.

    Article  Google Scholar 

  46. Mack D, Brantley K, Bell K. Mitigating the health effects of disasters for medically underserved populations: electronic health records, telemedicine, research, screening, and surveillance. J Health Care Poor Underserved. 2007;18(2):432–42.

    PubMed  Article  Google Scholar 

  47. Ferrari A, Rideout B. The collaboration of public health nursing and primary care nursing in the development of a nurse managed health center. Nurs Clin N Am. 2005;40(4):771–8.

    Article  Google Scholar 

  48. Heller B, Goldwater M. The Governor’s Wellmobile: Maryland’s Mobile primary care clinic. J Nurs Educ. 2004;43(2):92–4.

    PubMed  Article  Google Scholar 

  49. Lambrew J, Ricketts T, Morrissey J. Case study of the integration of a local health department and a community health center [internet]. Uncch.pure.elsevier.com. 2018. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403326/pdf/pubhealthrep00069-0021.pdf.

  50. Alexy B, Elnitsky C. Community outreach: rural Mobile health unit. J Nurs Adm. 1996;26(12):38–42.

    CAS  PubMed  Article  Google Scholar 

  51. Chambers W, Kaczorowski J, Dolovich L, Karwalajtys T, Hall L, McDonough B, et al. A community-based program for cardiovascular health awareness. Can J Public Health. 2005;96:294–8.

    PubMed  Article  PubMed Central  Google Scholar 

  52. Mayo K, White S, Oates S, Franklin F. Community collaboration: prevention and control of tuberculosis in a homeless shelter. Public Health Nurs. 1996;13(2):120–7.

    CAS  PubMed  Article  Google Scholar 

  53. Kizer K. Clinical integration: a cornerstone for population health management. J Healthc Manag. 2015;60(3):164–8.

    PubMed  Article  Google Scholar 

  54. Bourdages J, Sauvageau L, Lepage C. Factors in creating sustainable intersectoral community mobilization for prevention of heart and lung disease. Health Promot Int. 2003;18(2):135–44.

    PubMed  Article  Google Scholar 

  55. Brocklehurst N, Rowe A. The development and application of a public health skills assessment tool for use in primary care organisations. Public Health. 2003;117(3):165–72.

    PubMed  Article  Google Scholar 

  56. Suter E, Oelke N, Adair C, Armitage G. Ten key principles for successful health systems integration. Healthcare Q. 2009;13(sp):16–23.

    Article  Google Scholar 

  57. Bruckner J, Barr B. Data-driven population health. N C Med J. 2014;75(3):200–1.

    PubMed  Google Scholar 

  58. Chen E. Improving population health through team-based panel management. Arch Intern Med. 2011;171(17):1558.

    PubMed  Article  Google Scholar 

  59. Price D, Chan D, Greaves N. Physician surveillance of influenza: collaboration between primary care and public health. Can Fam Physician. 2014;60(1):e7–15.

    PubMed  PubMed Central  Google Scholar 

  60. Allan J, et al. Clinical prevention and population health: curriculum framework for health professions. Am J Prev Med. 2004;27(5):471–6.

    PubMed  PubMed Central  Google Scholar 

  61. Hripcsak G, Knirsch C, Jain N, Stazesky R, Pablos-Mendez A, Fulmer T. A health information network for managing Innercity tuberculosis: bridging clinical care, public health, and home care. Comput Biomed Res. 1999;32(1):67–76.

    CAS  PubMed  Article  Google Scholar 

  62. Voelker R. Population-based medicine merges clinical care, epidemiologic techniques. JAMA. 1994;271:1301–2.

    CAS  PubMed  Article  Google Scholar 

  63. Brauer P, Schneider T, Preece C, Northmore D, West E, Dietrich L, et al. Promoting healthy lifestyles in Ontario family health networks. Can J Diet Pract Res, Fall 2006 supplement on primary care. 2006:s39–46.

  64. Bradley S, David S. General practitioners with a special interest in public health; at last a way to deliver public health in primary care. J Epidemiol Community Health. 2005;59:920–3.

    PubMed  PubMed Central  Article  Google Scholar 

  65. Peckham S, Hann A, Boyce T. Health promotion and ill-health prevention: the role of general practice. Qual Prim Care. 2011;19:317–23.

    PubMed  Google Scholar 

  66. Etz S, Cohen J, Woolf H, Holtrop S, Donahue E, et al. Bridging primary care practices and communities to promote healthy behaviors. Am J Prev Med. 2008;35:S390–7.

    PubMed  Article  Google Scholar 

  67. Kuo A, Etzel R, Chilton L, Watson C, Gorski P. Primary care pediatrics and public health: meeting the needs of Today’s children. Am J Public Health. 2012;102(12):e17–23.

    PubMed  PubMed Central  Article  Google Scholar 

  68. Flynn C. Healthy cities: toward worldwide health promotion. Annu Rev Public Health. 1996;17:299–309.

    CAS  PubMed  Article  Google Scholar 

  69. Hancock T. The evolution, impact and significance of the healthy cities/healthy communities movement. J Public Health Policy. 1993;14:5–18.

    CAS  PubMed  Article  Google Scholar 

  70. Kharrazi H, Lasser C, Yasnoff A, Loonsk J, Advani A, Lehmann P, et al. A proposed national research and development agenda for population health informatics: summary recommendations from a national expert workshop. J Am Med Inform Assoc. 2017;24(1):2–12.

    PubMed  Article  Google Scholar 

  71. Hatef E, Kharrazi H, VanBaak E, Falcone M, Ferris L, Mertz K, et al. A state-wide health IT infrastructure for population health: building a community-wide electronic platform for Maryland’s all-payer global budget. Online J Public Health Inform. 2017;9(3):e195.

    PubMed  PubMed Central  Article  Google Scholar 

  72. Self-assessment tool for the evaluation of essential public health operations in the WHO European Region, World Health Organization 2015.


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From: A population-based approach to integrated healthcare delivery: a scoping review of clinical care and public health collaboration

Intervention Key features
A. Coordinate clinical services with community services (across different sites) Combining clinical services (diagnosis, prevention, treatment rehabilitation) with:
1. Counseling and educational services directed at personal risk behaviors, the management of particular health problems, the use of health services etc.
2. Outreach and case management services to identify health needs of individuals and promote compliance with complex treatment programs
3. Social services that address socioeconomic determinants of health
B. Bring other sector’s personnel (E.g. public health) to existing practice sites 1. PC sites can lease certain services from PH departments, and vice versa
2. Organizations can hire or contract professionals with expertise or experience in providing a desired service
3. PC or PH sites bring in outside personnel to provide individual-level support services for patients
C. Establish “one-stop” centers (geographic proximity) 1. Co-location of both sectors’ services to promote geographical proximity of PC and PH professionals and programs
2. Addressing health inequalities through “one-stop” centers located in disadvantaged regions and organized around needs of local populations