This paper, written in partnership with the UK’s National Association of Primary Care, and developed also with Public Health England, describes the rationale for measuring not just absence of disease but wellness. It compares several currently available metrics and suggests how they can be used to drive change within healthcare itself, but also in sectors as diverse as education, employment, and related areas such as policing.
1Why the focus on wellness rather than just absence of disease?
In part it’s because wellness is actually the goal we want to achieve. But interestingly, there’s research that tells us that people with a strong sense of wellbeing use the health system better, adopt new behaviors better, and achieve better outcomes. It’s almost as if by aiming for more than mere absence of sickness, you do a better job of preventing and treating disease.
2What did you look for in evaluating wellness metrics?
There are some obvious things: It needs to be cost effective, simple to administer, and easy to understand. It needs to be well-accepted, with a body of scientific data to support it. But we also wanted to be sure we chose something broadly applicable. Wellness is not just a matter of your interactions with the health system. We need a metric that can also be used by schools, employers, social services, and even the criminal justice system.
3What about “hard” medical data?
We think it’s absolutely necessary, and there are some useful metrics already available. One particularly useful one counts the number of emergency bed days—that is, the total amount of non-elective hospital utilization—per thousand patients age 65 and up. In England, that ranges from about 1,500 to almost 4,500, a large gap. And we know of accountable care organizations in the U.S. that have achieved rates of around 800—an ambitious goal to shoot for.