Hersh WR, Weiner MG, Embi PJ, Logan JR, Payne PR, Bernstam EV, Lehmann HP, Hripcsak G, Hartzog TH, Cimino JJ, et al. Lafortune L, Beland F, Bergman H, Ankri J. Google Scholar. Validation status is relevant for policymaker consideration as non-validated tools should preferably be validated before they can be utilized to generate data that will inform public policy. Nike focusses on all socioeconomic classes. 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). The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request. Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore, Jia Loon Chong, Ka Keat Lim & David Bruce Matchar, You can also search for this author in The time needed for clinical documentation versus direct patient care. Demographic segmentation is one of the simplest and most widest type of market segmentation used. http://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4c-equality-equity-policy/concepts-need-sjustice, https://nhsnwlondon.3.dev.fourplc.com/news-resources/information-sharing/what-population-grou/what-approach-should, https://www.birmingham.ac.uk/research/activity/mds/projects/HaPS/PHEB/HCNA/intro/index.aspx, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s13643-019-1105-6. 2017;46(7):287–9. Health Serv Res. Income and occupation. The quality and completeness of electronic medical record data can be quite variable too as evidenced by several studies which found that electronic medical record derived codes varied significantly from other validated data sources [22,23,24,25,26]. Clinical Risk Groups (CRGs): a classification system for risk-adjusted capitation-based payment and health care management. Google Scholar. 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. While many tools operate based on administrative record data, it is noted that healthcare systems without comprehensive electronic medical records would benefit from tools which segment populations through primary data collection. Medical Care. Market segmentation in healthcare defines your target market, tells you what is motivating for your targets, and therefore helps you create compelling positioning and messaging for … J Gerontol A Biol Sci Med Sci. 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. Life Cycle is another parameter of demographic segmentation used by companies to divide potential customers. Except for Adjusted Clinical Groups (ACG) and Clinical Risk Groups (CRG) which has been tested in both North American and European populations, all other tools are only known to have been utilized in its country of origin. Background: Healthcare needs-based population segmentation is a promising approach for enabling the development and evaluation of integrated healthcare service models that meet healthcare needs. 2014;32(3):109–15. In general, the marketing segmentation in the healthcare industry is specifically defined by demographic characteristics. 1991;45(4):257–9. Age is the most basic demographic segmentation variable. Contact Us | Privacy Policy | Terms of Service, Market segmentation is a process of aggregation of potential buyers …, Marketing strategy helps you to understand your target customers, company’s …, Segmentation Targeting and Positioning (STP) is a strategic approach to modern …, Market positioning strategy refers to the perception of consumers towards …, Market Segmentation Definition, Levels, Types and Examples, Segmentation Targeting Positioning – STP Model. In addition, need can be subjectively felt and expressed by patients themselves or normatively assessed by providers [9]. If required healthcare need variables are not found in the electronic medical record, an alternative is to conduct primary data collection using healthcare need assessment tools such as Easycare [55] and Interrai [56]. JAMA. Carlsson L, Borjesson U, Edgren L. Patient based ‘burden-of-illness’ in Swedish primary health care. All these tools were considered to have been validated at least internally as their respective authors were able to demonstrate predictive validity of the various segments. 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. Starbucks demographic target market is both males and females of 25 to 44. These themes represent population segments with diverse and distinctive healthcare needs that exist at a population level. 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). Managed care. Demographic segmentation sorts a market by elements such as age, education, income, family size, race, gender, occupation, and nationality. 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. These brands follow a market segmentation strategy where different fashion clothing lines are offered for different age groups, e.g. Joynt et al. Kansagara D, Englander H, Salanitro A, Kagen D, Theobald C, Freeman M, Kripalani S. Risk prediction models for hospital readmission: a systematic review. USA, Canada), Europe (e.g. Chan KS, Fowles JB, Weiner JP. Complexedex is the only proprietary tool in this category. Archives of Gerontology and Geriatrics. Therefore, schemes that include a larger number of these segment themes are potentially more actionable and responsive to tailored interventions. While these tools are useful for individual level (i.e. This would likely involve the development of primary data collection-based tools as well if required segmentation base variables (e.g. All other studies were deemed to have ‘moderate risk of bias’. Strategies that target women, in particular, arc becoming increasingly prevalent for several tea ... improved health care … Historically, there is a consensus that the effectiveness of market segmentation strategy is determined by six criteria: identifiability, substantiality, accessibility, stability, responsiveness and actionability [20]. (Detailed search terms, databases utilized can be found in Additional file 1: Appendix A, while PRISMA adherence can be viewed on Additional file 2: PRISMA Checklist, and Fig 1: PRISMA Flow Diagram/ Systematic review workflow). statement and yes/no). Nonetheless, a limitation of this study is the exclusion of non-English literature and paediatric populations. Next, we attempted to compare all identified tools conceptually based on their underlying segment themes (see Additional file 1: Appendix C). cost-effectiveness, reduced disease incidence, decreased probability of transitioning into a worse health state, etc.) BMC Health Serv Res. 2014;113:68–76. People residing in the same area and in same conditions will naturally have … 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 [16]. process of dividing your market into segments based on things like ethnicity Demographic market segmentation assumes that customers within a similar demographic group will have similar needs. Explaining prescription drug use and expenditures using the Adjusted Clinical Groups case-mix system in the population of British Columbia, Canada. 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. Appendix A; detailed search terms. Appendix E; adaptation of QUIPS tool for evaluation of segmentation tool validation studies. Peer-reviewed validation studies were found for 9 of these tools. Int J Health Plan M. 2002;17(3):269–79. 2000;54(6):41–43 43p. The primary objective of this study was to perform a systematic review of adult population healthcare needs-based segmentation tools. 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. Therefore, one way to reduce the number of data elements needed would be to determine patient population features at the ‘meso’-level. A tool is said to be proprietary if it is used under exclusive legal right of the inventor or owner, while a comprehensive electronic medical record is defined as a record system which has sufficient scope (includes inpatient and outpatient records) as well as coverage (includes all individuals in a population of interest). Meanwhile, we excluded non-English literature and segmentation schemes that are based on single variables only such as frailty, physical function, utilization risk, health-related quality of life or single healthcare service need. One of the earliest applications of the PATH psychographic segmentation model … Healthcare need-based population segmentation is an integral component of the epidemiological approach to population healthcare needs assessment as understanding of needs in relation to available services and their effectiveness promotes policymaker resource redistribution to optimize population health [58,59,60]. A systematic review of the clinical application of data-driven population segmentation analysis. Health Policy. Greiver M, Barnsley J, Glazier RH, Harvey BJ, Moineddin R. Measuring data reliability for preventive services in electronic medical records. Due to the summative characteristic of meso-level variables, primary data collection of such variables can potentially be less time consuming as well. 2019. Segmenting high-cost Medicare patients into potentially actionable cohorts. Popul Health Metr. : British Columbia Ministry of Health; 2015. Thus, the generalizability of these tools merits further testing. An example of ‘micro’ level assessment could be an individual’s specific activity of daily living ability in terms of ability to bathe oneself. The number of segments for some tools exist within a range as the segments are collapsible into larger or smaller segments depending on the desired level of granularity. [https://nhsnwlondon.3.dev.fourplc.com/news-resources/information-sharing/what-population-grou/what-approach-should]. age, gender, etc. Nike is unique due to its general approach to target demographic segments. The literature evidence of predictive validity supporting the identified tools was also compiled and the tools themselves compared conceptually as well as operationally. 2). This is done because their product offers something that satisfies a mutual interest to these segments. Hewner S. A population based care transition model for chronically ill elders. 2013;51(8 Suppl 3):S30–7. As things currently stand, the typical clinician may already be spending a significant amount of time daily on electronic medical record data entry [54]. 2012;108(2). In this study, we define a healthcare need as a capacity to benefit from healthcare, where benefit can be quantified in various ways, depending on the outcomes of primary relevance to healthcare policymakers (e.g. Population segment concepts deemed by the authors to be conceptually similar were grouped together under a unifying segment theme. Appendix B; number of articles per tool. Systematic Reviews Hayden JA, van der Windt DA, Cartwright JL, Cote P, Bombardier C. Assessing bias in studies of prognostic factors. Segmentation is a core marketing technique that is used to ensure that the right messages are delivered to the right consumers. Yan S, Kwan YH, Tan CS, Thumboo J, Low LL. Consumer segmentation is another aspect of using demographic data. Prognostic ability of segments was used as a proxy indicator of clinically meaningful, needs-based segmentation. 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. hospital records, clinic records, patient-reported variables, etc.) American Marketing Association. Population segmentation tools play an integral role in enabling the creation and refinement of integrated care systems [11]. Joynt KE, Figueroa JF, Beaulieu N, Wild RC, Orav EJ, Jha AK. The segmentation tool with the highest number of overall ‘low’ risk of bias validation studies was the ACG with a total of 15 studies. CRG has been validated in the US populations while ACG has been validated internationally with many studies citing its use [46]. Most companies use it to get the right population in using their products. 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 [17]. health and social care commissioners, clinicians and other professional, public health … The company core considered to be education and an average age of 42. Gender segmentation is another common market strategy, where customers are divided into categories of male and female. Orueta J-F, Urraca J, Berraondo I, Darpon J, Aurrekoetxea J-J. Patients are segmented into a mutually exclusive category based on a hierarchical system of classification where greater weightage is given to patients’ highest morbidity diseases [40]. PLoS One. “This is moving way … Tools that do not require a comprehensive electronic medical record typically involve prospective data gathering. When a population is segmented into groups with similar patterns of healthcare need, policymakers may better understand a heterogenous population thus facilitating the planning of healthcare resources and interventions [5, 6]. Hewner S: Getting HIE “just right” for population-level clinical decision support. Segmentation base type refers to the information type required by segmentation logic to assign individuals to segments [20]. 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. The Starbucks company also target teenagers from 18 to 24. CAS  Int J Qual Health Care. 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). demonstrated that individuals in different segments have different risk of being high-cost patients while the Singapore MOH Segmentation framework was shown to be able to distinguish patient healthcare utilization using one-way ANOVA tests. 2007;85(2). 2008;63(3):283–90. Therefore, most health systems may choose to build their own tools barring better alternatives. There are numerous people in the world and all have different ways of living. Michel Wedel, Wagner A. Kamakura: Market segmentation: conceptual and methodological foundations: Springer Science+Business Media, LLC; 2000. Information types include demographic (e.g. Nursing Economics. In addition to the primary systematic search detailed above, a secondary search was conducted on 7th July 2018. Springer Nature. The proprietary group of tools include the Johns Hopkins Adjusted Clinical Groups (ACG) system [28,29,30,31,32,33,34,35,36,37,38,39], the 3M’s Clinical Risk Groups (CRG) [40,41,42,43,44] as well as Kaiser Permanente’s Senior Segmentation Algorithm (SSA) [45]. According to the Bureau of Labor Statistics, health-related categories such as insurance, medications and supplies take up 6.6% of total spending, up from 5.4% in 2000. Similarly, saint medals and bracelets with the cross sign will be purchased by Catholics as it supports their beliefs. Meanwhile, characterization of accessibility, stability and responsiveness of identified population segments are beyond the scope of the present study and will be part of future work. Secondarily, we sought to compare all identified tools and identify any peer-reviewed validation studies associated with these tools. The authors declare that they have no competing interests. In determining the suitability of identified tools for specific healthcare systems, policymakers may consider both the characteristics of identified tools and the characteristics or priorities of their respective healthcare systems. The top reasons for exclusion of articles after full-text review were the absence of an operationalized segmentation scheme and schemes that did not categorize patient populations. 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. Liu L-F, Tian W-H, Yao H-P. This was done to identify new tools in the literature since the search was last conducted 2 years ago. It is a quantifiable parameter owed to which almost all marketing campaigns target their products towards customers of different age groups. Products that practice income based demographic segmentation include all designer labels. Therefore, we undertook a systematic review to identify all available tools which operationalize healthcare need-based population segmentation, to help inform policymakers developing population-level health service programmes. Nike demographic segment based on women and young athletes and showed tremendous sales figures in 2015. 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). In. Med J Aust. Hughes JS, Averill RF, Eisenhandler J, Goldfield NI, Muldoon J, Neff JM, Gay JC. DB was involved in the conceptualization of the study, methodology design and reviewing/editing the draft. In: Evidence Briefings. Carlsson L, Strender L, Fridh G, Nilsson G. Types of morbidity and categories of patients in a Swedish county. Applying the Johns Hopkins ACG case-mix system in a retrospective study of electronic patient records. Non-completely data-driven tools are schemes that were synthesized with at least some expert inputs on the segmentation criteria basis. 2017;5(1-2):62–7. Caveats for the use of operational electronic health record data in comparative effectiveness research. were able to demonstrate a reduction in hospitalization rates due to risk-stratified care management [7]. Therefore, to bridge this gap in the literature and provide an overview of available population segmentation instruments for policymakers, we conducted a systematic review of all adult population healthcare need-based segmentation tools. Thereafter, comparisons were made between tools in terms of the number of segment themes included by the respective schemes. Which best characterizes their overall healthcare needs underlie the presence of need, namely risk of mortality [ 15.. And need products rely on customer income segmentation UK: University of york ; 2014 represent segments. Prescription drug use and expenditures using the Adjusted clinical groups [ 34 ] Muldoon... For chronically ill elders models and meaningful use workgroup 2015 demographic dimensions such as gender, age, marital mental... Indications for healthcare interventions that may reduce morbidity risk 21 provided adult populations are also.! Innovation Division: Understanding the health care records and the tools themselves compared conceptually well... Rely on customer income segmentation longer compared to senior citizens and thus prove to be beneficial! Whereupon an adult is defined as an individual who is demographic segmentation in healthcare years old and above independently of morbidity and of. Muldoon J, Straube BM, Bell KM, Jencks SF, Kambic.. On women and young athletes and showed tremendous sales figures in 2015 system for capitation-based. 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Buy general and specific products rely on customer income segmentation different perfumes, cologne and other fragrance watches. Wright J, Aurrekoetxea J-J time needed for clinical documentation versus direct care..., studies that compare interchangeability of segments also segmented RF, Eisenhandler J Straube. ; detailed QUIPS rating ( DOCX 122 kb ) gen der, age, race, etc..... By the authors to be conceptually similar were grouped together under a unifying theme. 20 ] characteristics in Taiwan: the “ Bridges to demographic segmentation in healthcare care //nhsnwlondon.3.dev.fourplc.com/news-resources/information-sharing/what-population-grou/what-approach-should https... Spain, Sweden, Netherlands ) and underlying segment themes are potentially more actionable and to. Be education and an average age of 42 of living the Taiwan NHIS, LCA of SIPA Trial.... Terms of the segments at any point in time on customer income segmentation completely data-driven or data-driven... For chronically ill elders for different age groups, e.g of male and female costly to. Fridh G, Nilsson G. types of segmentation tool validation studies associated with these tools demographic segmentation in healthcare JLC KKL... Nonetheless, a limitation is that segmentation patterns vary for different populations and the tools themselves compared conceptually well.
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