Estimating community health needs against a Triple Aim background: What can we learn from current predictive risk models?

- This paper provides a compositional overview of 10 Dutch predictive risk models.
- Frequently used determinants are age, income and geographic region.
- Most models also tend to include illness level determinants of health needs.
- Creating community-focused care will likely need a more holistic assessment approach.
- This may require policies to promote data integration from various sources.

IntroductionTo support providers and commissioners in accurately assessing their local populations' health needs, this study produces an overview of Dutch predictive risk models for health care, focusing specifically on the type, combination and relevance of included determinants for achieving the Triple Aim (improved health, better care experience, and lower costs).MethodsWe conducted a mixed-methods study combining document analyses, interviews and a Delphi study. Predictive risk models were identified based on a web search and expert input. Participating in the study were Dutch experts in predictive risk modelling (interviews; n = 11) and experts in healthcare delivery, insurance and/or funding methodology (Delphi panel; n = 15).ResultsTen predictive risk models were analysed, comprising 17 unique determinants. Twelve were considered relevant by experts for estimating community health needs. Although some compositional similarities were identified between models, the combination and operationalisation of determinants varied considerably.ConclusionsExisting predictive risk models provide a good starting point, but optimally balancing resources and targeting interventions on the community level will likely require a more holistic approach to health needs assessment. Development of additional determinants, such as measures of people's lifestyle and social network, may require policies pushing the integration of routine data from different (healthcare) sources.