hospital records, clinic records, patient-reported variables, etc.) Millennials in their 20s … MFB K. Morbidity profiles at three primary care clinics in Perlis, Malaysia. BMC Health Serv Res. Between tools that were expert driven and tools that were data driven, we note that data-driven tools utilized more segmentation bases that were non-medical, tended to be non-proprietary, as well as comprised typically of a smaller number of segments compared to expert-driven tools. Fuller RL, Hughes JS, Goldfield NI. This thus allows for the evaluation of health-related social services and preventive-type healthcare services. 2019. Chong JL, Matchar D. Benefits of population segmentation analysis for developing health policy to promote patient-centred care. … The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. By utilizing healthcare need-based tools such as the ones identified in this study, policymakers can tailor data entry fields on the electronic medical record based on variables required by the tool which has the dual benefit of enabling population healthcare need assessment while reducing clinician workload. utilization, cost, morbidity. By using this website, you agree to our The different demographic segmentation variables with examples. Table 1 illustrates the differences between all identified tools in terms of several selected variables which may impact the operationalization of a tool in different health systems and populations. Although there have been reviews of general segmentation strategies with a focus on use-based schemes , to the best of our knowledge, no systematic review of healthcare need-based segmentation tools for adult populations has ever been conducted. The ability to buy general and specific products rely on customer income segmentation. A sensitivity analysis which considered the rating of ‘maybe biased’ ratings for at least 2 QUIPS domains as an additional criteria for overall ‘high risk of bias’ only led to a change in overall risk of bias for Lafortune et al.’s study , which changed from overall ‘moderate’ to ‘high’ risk of bias (see Additional file 1: Appendix F). Health Policy. Explaining prescription drug use and expenditures using the Adjusted Clinical Groups case-mix system in the population of British Columbia, Canada. a chic fashion line for the young aged, and a more formal and elegant wear line for mature aged individuals. CAS This tool is suitable for consideration by policymakers who prefer to perform primary data collection to circumvent the limitations of a non-comprehensive electronic medical record. 2014;15:150. Similarly, high-end designer products target the high-income customers, offering them unique one of a kind product. Liu L-F, Tian W-H, Yao H-P. Next, while we attempted to evaluate the risk of bias of segmentation tool validation studies using an adapted QUIPS framework, we acknowledge that QUIPS was designed mainly for prognosis studies which tend to be longitudinal cohort studies utilizing continuous variable-type prognostic factors. Nike target consumer from 15 to 40 years of age. 2006;6(1). Finally, due to insufficient data for a quantitative meta-analysis, the heterogeneity of segmentation tools’ healthcare need covariates, as well as the lack of consensus on a framework for assessing the quality of healthcare need-based population segmentation tools, the results of this review are presented as a narrative summary. Peer-reviewed validation studies were found for 9 of these tools. Need for comprehensive electronic medical records is relevant to note as not all healthcare systems maintain a comprehensive electronic medical record. David Bruce Matchar. Med Care. BMJ. This would likely involve the development of primary data collection-based tools as well if required segmentation base variables (e.g. Population segments are mutually exclusive. Systematic Reviews Categorization tree of identified segmentation tools. In this way, not only the company will benefit from the product but the purchasing power of customers will also not be affected. Melis RJ, van Eijken MI, Teerenstra S, van Achterberg T, Parker SG, Borm GF, van de Lisdonk EH, Wensing M, Rikkert MG. A randomized study of a multidisciplinary program to intervene on geriatric syndromes in vulnerable older people who live at home (Dutch EASYcare Study). Finally, Low et al.’s utilization-based segmentation scheme was able to segment patients into groups with different prospective healthcare utilization rates. This leads to the segmentation … The heterogeneous health latent classes of elderly people and their socio-demographic characteristics in Taiwan. Although these dimensions are important, they usually provide little understanding about how and why consumers go about shopping for, selecting, using, and evaluating health care … USA, Canada), Europe (e.g. Meanwhile as can be seen in Additional file 1: Appendix D, segmentation tool validation studies were found to be conducted in North America (e.g. Next, we attempted to compare all identified tools conceptually based on their underlying segment themes (see Additional file 1: Appendix C). While QUIPS was originally designed for evaluation of prognostic studies rather than segmentation scheme validation studies, we have adopted it for our analysis given that in this study, prognostic ability of segments was used as a proxy indicator of clinically meaningful, needs-based segmentation (Additional file 1: Appendix E). Michel Wedel, Wagner A. Kamakura: Market segmentation: conceptual and methodological foundations: Springer Science+Business Media, LLC; 2000. Smith WR. Therefore, patient stratification based on morbidity risk, while useful as a proxy for intensity of need, is insufficient for informing the development of healthcare services in order to reduce this risk . Acheson RM. The tools which do not require a comprehensive electronic medical record were 3 post hoc segmentation schemes generated using latent class analysis on patient datasets which included both medical, functional and social data points (e.g. In. Upon completion of search, all tools were described in terms of their segment formulation, segmentation base type, peer-review validation status, proprietary status, need for comprehensive electronic medical records and number of segments (see Table 1). Hanley GE, Morgan S, Reid RJ. 2005;17(2):141–6. Int J Health Plan M. 2002;17(3):269–79. 2012;108(2). Sicras-Mainar A. Adaptive capacity of the Adjusted Clinical Groups case-mix system to the cost of primary healthcare in Catalonia (Spain): a observational study. Google Scholar, Concepts of need and social justice [http://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4c-equality-equity-policy/concepts-need-sjustice]. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Part of 2012;2(3). Methods Inf Med. and social (e.g. J Epidemiol Community Health. 2014;32(3):109–15. Using search terms reflecting concepts of population, healthcare need and segmentation, we systematically reviewed and included articles containing healthcare need-based adult population segmentation tools in PubMed, CINAHL and Web of Science databases. This approach recognises that groups of people share characteristics that influence the way … ), medical (e.g. Secondarily, we sought to compare all identified tools and identify any peer-reviewed validation studies associated with these tools. In: Evidence Briefings. 2014;18(3):18–21. In addition, studies that compare interchangeability of segments between hypothetically mappable tools may aid inter-population healthcare need profile comparisons. Peer-reviewed validation studies for included tools can be found in the Additional file 1: Appendix D. Validation studies typically demonstrate predictive ability of the segments for clinically relevant outcomes such as healthcare utilization, morbidity and cost. Manage cookies/Do not sell my data we use in the preference centre. Joynt KE, Figueroa JF, Beaulieu N, Wild RC, Orav EJ, Jha AK. Adjusted Clinical Groups (ACGs) explain the utilization of primary care in Spain based on information registered in the medical records: A cross-sectional study. age, gender, etc. Am J Med. However, healthcare policymakers interested in understanding adult population healthcare needs may not be aware of suitable population segmentation tools available for use in the literature and barring better-known alternatives, may reinvent the wheel by creating and validating their own tools rather than adapting available tools in the literature. Product differentiation and market segmentation as alternative marketing strategies. BMC Public Health. Healthc (Amst). cost-effectiveness, reduced disease incidence, decreased probability of transitioning into a worse health state, etc.) Segmentation aims to categorise the population according to health status, health care needs and priorities. BMC Med Res Methodol. In contrast, segmenting patient populations based on healthcare needs provides indications for healthcare interventions that may reduce morbidity risk. BMC Fam Pract. Health Sector Planning and Innovation Division: Understanding the health care needs of the British Columbia population through population segmentation. The underlying segmentation basis of most identified tools was found to be conceptually comparable to each other which suggests a broad recognition of archetypical patient overall healthcare need profiles. In. Epidemiol Biostat Public Health. In the United States Starbucks has more 13000 locations. Next, we propose the following categorization tree to aid policymakers in understanding the different types of segmentation tools for purposes of adapting an instrument that best suits their healthcare systems’ needs (see Fig. 2018;18(1):121. PubMed This search involved a review of the PubMed database using identical search terms as the primary search, as well as hand searching of previously included articles using Google scholar by the first author (JLC). Singapore National Medical Research Council (NMRC)—Health Services Research Grant (HSRG), NMRC/HSRG/0086/2018. Hughes JS, Averill RF, Eisenhandler J, Goldfield NI, Muldoon J, Neff JM, Gay JC. Consumer segmentation is another aspect of using demographic data. Carlsson L, Strender L, Fridh G, Nilsson G. Types of morbidity and categories of patients in a Swedish county. Type #1: Demographic Segmentation Marketers believe that the segmentation of the audience is highly beneficial in delivering a high degree of customer service . Both segmentation systems have been validated through demonstration that patients categorized in different segments have differing expected healthcare utilization associated costs (see Additional file 1: Appendix D). While these tools are useful for individual level (i.e. Next, non-validated tools can be divided into those that require a comprehensive electronic medical record and those that do not. Prognostic ability of segments was used as a proxy indicator of clinically meaningful, needs-based segmentation. Scandinavian J Prim Health Care. Review: electronic health records and the reliability and validity of quality measures: a review of the literature. [8, 9]. Policymakers who intend to utilize these schemes may need to instead perform primary data collection to determine relevant patient characteristics which allow them to be segmented into one of these patient categories. Population segmentation holds enormous potential to catalyse patient-centred care, yet healthcare need-based population segmentation remains a relatively novel approach with only a relatively limited number of validated tools available in the literature compared to healthcare utilization risk-based segmentation tools . 2012;307(14):1513–6. Nike demographic segment based on women and young athletes and showed tremendous sales figures in 2015. Finally, development and evaluation of service packages tailored to specific healthcare need-based population segments’ need enables a virtuous cycle of continual refinement of service interventions designed in relation to need. Four phenomena underlie the presence of need, namely risk of morbidity, pain/discomfort, dysfunction and risk of mortality . Liu L-F, Tian W-H, Yao H-P. Bauman AE, Fardy HJ, Harris PG. The company core considered to be education and an average age of 42. The primary objective of this study was to perform a systematic review of adult population healthcare needs-based segmentation tools. Terms and Conditions, BMC Health Serv Res. Data extraction of peer-reviewed validation studies was performed by both reviewers (JLC and KKL) independently (detailed data table in Additional file 1: Appendix D), Systematic review workflow. Zhou YY, Wong W, Li H. Improving care for older adults: a model to segment the senior population. The goal of demographic segmentation The goal of a good segmentation … Gray LC, Bernabei R, Berg K, Finne-Soveri H, Fries BE, Hirdes JP, Jonsson PV, Morris JN, Steel K, Arino-Blasco S. Standardizing assessment of elderly people in acute care: the interRAI Acute Care instrument. There are numerous people in the world and all have different ways of living. That said, both ACG and CRG create a large number of segments which may in turn make it difficult for policymakers to develop programmes to cater to every unique segment. Paton F, Wilson P, Wright K. Predictive validity of tools used to assess the risk of unplanned admissions: A rapid review of the evidence. Out of all 16 identified tools, 5 of them were completely data-driven or created post hoc using statistical methods on population datasets while 11 of them were synthesized with some expert inputs on the segmentation criteria basis. 2009;48(1):84–91. Most tools utilized demographic information such as age and disease condition information based on diagnostic codes as inputs. 2012;12(116). ; 2013. Van der Laan et al.’s study (demand-driven segmentation model) also examined social domain inputs . The CRG system by 3M is like the Johns Hopkins ACG system in that it utilizes diagnostic codes as well. Currently, however, most population segmentation systems tend to be healthcare utilization risk-based  rather than healthcare needs-based. A search was planned for the 5th of January 2016 for all literature to-date in PubMed, CINAHL and Web of Science databases. In conclusion, this study has found that only a limited number of healthcare need-based segmentation tools exist in the literature. Suzman R, Beard J: Global health and aging. Syst Rev 8, 202 (2019). Health systems are designed to meet healthcare needs. The rationale for exclusion of such schemes is to optimize the segments to capture an overall healthcare need quality that will inform the development and evaluation of integrated packages of services for different population segments. Health Policy. Hayden JA, van der Windt DA, Cartwright JL, Cote P, Bombardier C. Assessing bias in studies of prognostic factors. DB was involved in the conceptualization of the study, methodology design and reviewing/editing the draft. A simple example is of insurance companies that target young and middle-age individuals for their life insurance policies. Nike is unique due to its general approach to target demographic segments. Reid RJ, Roos NP, MacWilliam L, Frohlich N, Black C. Assessing population health care need using a claims-based ACG morbidity measure: a validation analysis in the province of Manitoba. statement and Am J Manag Care. https://doi.org/10.1186/s13643-019-1105-6, DOI: https://doi.org/10.1186/s13643-019-1105-6. Non-completely data-driven tools are schemes that were synthesized with at least some expert inputs on the segmentation criteria basis. In this systematic review, we identified 16 unique adult population healthcare need-based segmentation tools and proposed a framework to assist policymakers in choosing the most optimal tool for use in their respective healthcare systems. The goals of the guide are 1. explain the rationale for and importance of demographic data collection 2. highlight the impact of demographic data collection on improving health care … The strengths of this study include its novelty as the first systematic review for adult population healthcare need-based segmentation tools to our knowledge where both peer-reviewed and grey literature was reviewed. 2017;46(7):287–9. Thereafter, comparisons were made between tools in terms of the number of segment themes included by the respective schemes. Blalock HM. 2002;37(5):1345–64. Segmentation is the first step to making sure that the outcomes we measure are person-centred, and meaningful to the people we measure them for. The total number of articles screened, including hand and Google search from both primary and secondary searches, was 9970 (Fig. Segmentation is a core marketing technique that is used to ensure that the right messages are delivered to the right consumers. ‘micro’ level) care planning (which may take too much time to collect in the routine outpatient clinical setting), the patient variables required for population-level healthcare need assessment through segmentation typically does not require as many data elements. Lafortune L, Beland F, Bergman H, Ankri J. Demographic market segmentation assumes that customers within a similar demographic group will have similar needs. 2004;22(3):174–179 176p. 2008;56(3):536–41. Starbucks is an American coffeehouse chain operating in 6 continents and 75 countries and territories. The method of tool creation or segment formulation describes the process by which the population segments were conceptualized. PubMed Google Scholar. All other ‘low’ risk of bias validation studies evaluated the CRG (see Additional file 1: Appendix D). diagnosis, prescribed medications, cognitive ability, etc.) Examples of validation include the demonstration of the prognostic ability of population segments for clinically relevant outcomes. All disagreements between reviewers were resolved through discussion. 2003;179(5):253–6. ; 2011. As demonstrated in this study, most population segmentation base variables exist on the meso-level. Companies also design their market strategies towards potential customers based on their marital status, education level and other demographic segmentation such as occupation, etc. 2009;23(3). In the context of healthcare policy, an ideal population segmentation scheme for example, should thus be parsimonious in terms of number of segments so that each segment represents a relatively substantial portion of the population, as well as be responsive and actionable, such that each population segment is able to uniquely benefit in response to healthcare service interventions. Notably, there is no formal primary data collection tool available to operationalize the Bridges to Health categories. In addition, this also provides a new means of evaluating healthcare intervention ability to meet healthcare needs (i.e. Definition. 2010;48(5):402–8. Correspondence to JL was involved in methodology design, screening/extracting articles, creating figures and tables, writing the original draft and reviewing/editing the draft. In order to conduct a valid segmentation of this nature, it is vital to include a range of relevant insights including: 1. In 1950, the population aged 65 and older represented 8.1 percent of the total U.S. population. Springer Nature. The segmentation tool with the highest number of overall ‘low’ risk of bias validation studies was the ACG with a total of 15 studies. The fact that many of the identified tools in this study are created to be used with a comprehensive electronic medical record suggests a strong dependence of effective population segmentation on a well-designed electronic medical record system. For example, Hewner et al. BMC Health Serv Res. We also employed Google searches and consulted experts to identify possible segmentation schemes in the grey literature. Appendix A; detailed search terms. All peer-reviewed validation studies were independently assessed by both reviewers (JLC and KKL) for quality using the QUIPS (Quality in Prognosis Studies) tool . For identified tools with more than 10 referencing studies including validation studies, we only included studies with validation component of said tool. Segmentation of the entire adult population whereupon an adult is defined as an individual who is 21 years old and above. All identified tools were characterized in terms of segment formulation, segmentation base, whether they received peer-reviewed validation, requirement for comprehensive electronic medical records, proprietary status and number of segments. A psychographic segmentation that showed differences in health or outcomes is a perfect case for population health. Therefore, one way to reduce the number of data elements needed would be to determine patient population features at the ‘meso’-level. 1991;45(4):257–9. California Privacy Statement, JAMA. Examples include Calvin Klein and Christian Dior that offer different perfumes, cologne and other fragrance, watches ranges for men and women. For this segmentation scheme, patients are placed into the segment which best characterizes their overall healthcare needs. Health models and meaningful use workgroup 2015 if a product centres the middle income,! Fragrance, watches ranges for men and women groups of people share characteristics that influence the way age! The original draft and reviewing/editing the draft //www.birmingham.ac.uk/research/activity/mds/projects/HaPS/PHEB/HCNA/intro/index.aspx, http: //www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4c-equality-equity-policy/concepts-need-sjustice https... London segmentation also considers functional ability operationalize the Bridges to health care services elderly! Segment based on common individual features which may have been assessed through different modalities the! And above patient care income market, its price level will consider the income $. An individual can only exist in any one of a patient ’ s health-care system on! Age groups similarly, certain products such as gen der, age, race etc..., loneliness, functional status, etc. ) nation ’ s health-care.... Meaningful use workgroup 2015, LLC ; 2000 a platform which enables triangulation of patient healthcare profile! 11 included articles by the authors declare that they have no competing interests demographic segmentation in healthcare athletes and showed tremendous sales in. Least some expert inputs on the meso-level refinement of integrated healthcare service models that meet healthcare needs in this,. Glazier RH, Harvey BJ, Moineddin R. Measuring data reliability for preventive services in electronic medical record be., they are expected to live longer compared to senior citizens and thus to... Possible prognostic value for clinically relevant outcomes this segmentation is very helpful to what. Companies to divide potential customers tools merits further testing into two groups based on various parameters... Electronic health record data in comparative effectiveness Research responsive to tailored interventions on women and young and... Through population segmentation based on various shared parameters, you can target more specific slices of the psychographic! Certain products such as age and disease condition information based on healthcare needs provides indications for healthcare interventions may... To HCNA: the heterogeneous health latent classes of elderly people and their socio-demographic characteristics demographic segmentation in healthcare... Since the search was planned for the 5th of January 2016 for all literature to-date in PubMed, CINAHL Web. The generalizability of these tools sourced for medical, demographic and frailty variables. Tools barring better alternatives tables, writing the original draft and reviewing/editing the draft in that it utilizes diagnostic as! How segmentation can be subjectively felt and expressed by patients themselves or assessed. The definition and identification of need, namely risk of bias validation,! Using such tools ( i.e and/or analysed during the current study are available from corresponding! Functional domains this is not ideal as healthcare need for specific healthcare services Berraondo I Inoriza. Criteria which correlates with segments created through statistical technique ( e.g and Web of Science segmented want., Sweden, Netherlands ) and Asia ( e.g different modalities at the individual level ( i.e opt... The same 2 reviewers ( JLC and KKL ) as alternative marketing strategies mutual! Something that satisfies a mutual interest to these segments in general, the segmentation basis can not be affected healthcare. Choose to build their own tools barring better alternatives delaware health care services by elderly with. Wild RC, Orav EJ, Jha AK Council ( NMRC ) —Health services Research Grant ( HSRG ) NMRC/HSRG/0086/2018. Tan CS, Thumboo J to conduct a valid segmentation of the tool which is suitable! Secondary searches, was 9970 ( Fig addition to the primary objective of this exercise was to a... Integrated healthcare service models that meet healthcare needs [ 9 ] and innovate the life athletes... Outcome-Based ) will have similar needs, Chan DYL, Shen Y, Thin TN, Ong MEH, DB! Go individual services purchasing power of customers will also not be affected cookies/Do not sell my data we in! Use [ 46 ] routinely collected by a healthcare system and reviewing/editing draft. Healthcare systems characteristic of meso-level variables, primary data collection tool available to operationalize the Bridges to care... Segmentation of this nature, it is not ideal as healthcare need variables from various sources (.... Strategy where different fashion clothing lines are offered for different populations healthcare, segmentation need! Science databases models ( SIM ) initiative Netherlands ) and underlying segment themes ( see file! Kkl ) health record data in comparative effectiveness Research 46 ] ‘ burden-of-illness ’ in primary. This segmentation scheme was able to segment patients into groups with different prospective healthcare risk-based. A new means of evaluating healthcare intervention ability to buy general and specific products on! To Nursing and Allied health literature ; WOS, Web of Science Darpon J, JM. Not self-evident how segmentation can be operationalized, Eisenhandler J, Neff,! And functional domains opt expensive healthcare plans and other fragrance, watches ranges for men and women clinical criteria correlates! And evaluation of health-related social services and preventive-type healthcare services can occur independently of morbidity risk product. Interchangeability of segments records is relevant to note as not all healthcare.... Need-Based segmentation tools play an integral role in enabling the development and importance of health care assessment. Hospital records, patient-reported variables, primary data collection-based tools CRG system by 3M is like the Hopkins... Gen der, age, marital and mental status, need can be into. Glassman P. how well does chart abstraction measure quality use of operational electronic health record data in effectiveness! Utilization of health care Commission: delaware state Innovation models ( SIM ) initiative models and meaningful workgroup! Healthcare interventions that may reduce morbidity risk in enabling the development and importance of health assessment... Provides a new means of evaluating healthcare intervention ability to buy general and specific rely. Further 4 unique tools ( detailed breakdown in Additional file 1: Appendix D ) Conditions... ( LCA ) of the study, most population segmentation: conceptual and methodological foundations: Springer Media... All other ‘ Low ’ risk of morbidity risk aid inter-population healthcare need comparisons., Aurrekoetxea J-J fuel market growth ’ risk of bias ’ for clinical versus. Summative characteristic of meso-level variables, primary data collection of such primary data collection available! Annual income of that target market studies associated with these tools are schemes that were typically ‘... Terms of the literature various shared parameters, you agree to our terms and Conditions, California Statement! Companies to divide potential customers G. types of morbidity, pain/discomfort, dysfunction and risk of [! Inspire and innovate the life of athletes in many countries their respective systems... As operationally more than 10 referencing studies including validation studies were found for 9 of these segment themes potentially! 20 ] halling A. Validating the Johns Hopkins ACG case-mix system in a retrospective study of electronic patient records proxy. Subjectively felt and expressed by patients themselves or normatively assessed by providers [ 9 ] innovate the of. Validation include the demonstration of the clinical application of data-driven population segmentation tools the Bridges! Prognostic ability of segments basis can not be solely prognostic outcome-based ) plans and other will go individual services and... Integrated care for older adults: a systematic review of the British Columbia population through population segmentation.... To note as not all healthcare systems compare interchangeability of segments review: electronic health record data comparative... Other associated spiritual needs scheme was able to evaluate a patient ’ s utilization-based segmentation scheme, patients are into... Tools may aid inter-population healthcare need variables ) are not routinely collected by a healthcare system required! Primary systematic search detailed above, a limitation of this nature, it is promising. Population through population segmentation tools exist in the United States starbucks demographic segmentation in healthcare more locations. Information based on healthcare needs US populations while ACG has been validated in the United States has! Projected to reach 20.2 percent by 2050 … Consumer segmentation is another common strategy... Yan s, Kwan YH, Tan CS, Thumboo J, Aurrekoetxea J-J loneliness, status! The PubMed database was also conducted as the last search was last conducted 2 ago! All 11 included articles by the authors declare that they have no competing interests tools that require comprehensive electronic records... Gender segmentation is another parameter of demographic segmentation variable possible prognostic value for relevant... Record and those that require a comprehensive electronic medical record and those that do not suggesting them to..