title: Which Triple Aim related measures are being used to evaluate population management initiatives? An international comparative analysis.
abstract: BACKGROUND
  Population management (PM) initiatives are introduced in order to create sustainable health care systems. These initiatives should focus on the continuum of health and well-being of a population by introducing interventions that integrate various services. To be successful they should pursue the Triple Aim, i.e. simultaneously improve population health and quality of care while reducing costs per capita. This study explores how PM initiatives measure the Triple Aim in practice.
  
  
  METHODS
  An exploratory search was combined with expert consultations to identify relevant PM initiatives. These were analyzed based on general characteristics, utilized measures and related selection criteria.
  
  
  RESULTS
  In total 865 measures were used by 20 PM initiatives. All quality of care domains were included by at least 11 PM initiatives, while most domains of population health and costs were included by less than 7 PM initiatives. Although their goals showed substantial overlap, the measures applied showed few similarities between PM initiatives and were predominantly selected based on local priority areas and data availability.
  
  
  CONCLUSIONS
  Most PM initiatives do not measure the full scope of the Triple Aim. Additionally, variety between measures limits comparability between PM initiatives. Consensus on the coverage of Triple Aim domains and a set of standardized measures could further both the inclusion of the various domains as well as the comparability between PM initiatives.
authors.affiliation: Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, PO Box 90153, 5000 LE Tilburg, The Netherlands. Electronic address: roy.hendrikx@rivm.nl.
authors.forename: Roy J P
authors.initials: RJ
authors.lastname: Hendrikx
authors.affiliation: National Institute for Public Health and the Environment, Center for Nutrition, Prevention and Health Services, Department for Quality of Care and Health Economics, PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: hanneke.drewes@rivm.nl.
authors.forename: Hanneke W
authors.initials: HW
authors.lastname: Drewes
authors.affiliation: Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Department of Health Services Research, PO Box 616, 6200 MD Maastricht, The Netherlands; Zuyd University of Applied Sciences, Research Centre for Technology in Care, PO Box 550, 6400 AN Heerlen, The Netherlands. Electronic address: m.spreeuwenberg@maastrichtuniversity.nl.
authors.forename: Marieke
authors.initials: M
authors.lastname: Spreeuwenberg
authors.affiliation: Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Department of Health Services Research, PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: d.ruwaard@maastrichtuniversity.nl.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ruwaard
authors.affiliation: National Institute for Public Health and the Environment, Center for Nutrition, Prevention and Health Services, Department for Quality of Care and Health Economics, PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: jeroen.struijs@rivm.nl.
authors.forename: Jeroen N
authors.initials: JN
authors.lastname: Struijs
authors.affiliation: Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, PO Box 90153, 5000 LE Tilburg, The Netherlands; National Institute for Public Health and the Environment, Center for Nutrition, Prevention and Health Services, Department for Quality of Care and Health Economics, PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: caroline.baan@rivm.nl.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Baan
mesh_terms: D003266:Continuity of Patient Care / Q000191:economics / Q000458:organization & administration*; D019468:Disease Management; D014943:Global Health; D006801:Humans; D011314:Preventive Health Services; D011787:Quality of Health Care
keywords: Costs; Measures; Population health; Population management; Quality of care; Triple Aim