Brent Braveman; Population Health and Occupational Therapy. Am J Occup Ther 2015;70(1):7001090010p1-7001090010p6. doi: 10.5014/ajot.2016.701002.
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© 2017 American Occupational Therapy Association
Occupational therapy practitioners play an important role in improving the health of populations through the development of occupational therapy interventions at the population level and through advocacy to address occupational participation and the multiple determinants of health. This article defines and explores population health as a concept and describes the appropriateness of occupational therapy practice in population health. Support of population health practice as evidenced in the official documents of the American Occupational Therapy Association and the relevance of population health for occupational therapy as a profession are reviewed. Recommendations and directions for the future are included related to celebration of the achievements of occupational therapy practitioners in the area of population health, changes to the Occupational Therapy Practice Framework and educational accreditation standards, and the importance of supporting, recognizing, rewarding, and valuing occupational therapy practitioners who assume roles in which direct care is not their primary function.
Primary care and value-based payment (Leland, Crum, Phipps, Roberts, & Gage, 2015; Stoffel, 2013)
The role of healthy habits and occupational therapy’s role in wellness and prevention as a strategy to maintain its relevance (Hildenbrand & Lamb, 2013; Persch, Lamb, Metzler, & Fristad, 2015)
New models of interdisciplinary team practice and a vision of health care as “a coordinated system built on teams of professionals with many capabilities and varied scopes of practice all focused on achieving health” (Metzler, Hartmann, & Lowenthal, 2012, p. 267; Moyers & Metzler, 2014)
Increased use of information technologies supported by the Centers for Medicare and Medicaid Services (CMS) and telehealth (Cason, 2015; Moyers & Metzler, 2014)
The Triple Aim and client centeredness as providing “a compass for future research demonstrating occupational therapy’s value through improved outcomes for health care recipients, increased efficiency of care transitions and prevention of hospital readmissions, and cost-effectiveness of interventions and programs when effectively and efficiently provided on the basis of best practice” (Lamb & Metzler, 2014, p. 9; Mroz, Pitonyak, Fogelberg, & Leland, 2015)
Evidence and promotion of the distinct value of occupational therapy (Arbesman, Lieberman, & Metzler, 2014).
that health outcomes were more than the absence of disease;
that these outcomes were produced by complex interactions of multiple determinants (health care, behaviors, genetics, the social environment, the physical environment); and
that in a resource-limited world, the relative cost effectiveness of these determinants was critical for policymakers. (para. 2)
either by (1) starting from the community and thinking about the needs of populations and then integrating with clinical care, or (2) starting from the individual needs of patients and learning about the social or community factors that are impacting their health and addressing these needs through policy or systems change. (as cited in Alper, 2014, p. 26)
the shift includes a growing recognition that the health care delivery system is responsible for only a modest proportion of what makes and keeps Americans healthy and that health care providers and organizations could accept and embrace a richer role in communities, working in partnership with public health agencies, community-based organizations, schools, businesses, and many others to identify and solve the thorny problems that contribute to poor health. (p. 2)
Interventions provided to groups and populations are directed to all the members collectively rather than individualized to specific people within the group. Practitioners direct their interventions toward current or potential disabling conditions with the goal of enhancing the health, well-being, and participation of all group members collectively. (AOTA, 2014a, p. S15)
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