Patient Segmentation: Adjust the Production Logic to the Medical Knowledge Applied and the Patient's Ability to Self-Manage—A Discussion Paper

摘要

This discussion paper argues that population segmentation according to healthcare needs and risks – the usual approach – might help to identify patients for targeted action, but does not inform how to design efficient service delivery. In other service industries customer segmentation is typically done based on customer preferences. Products or services are customised and marketing strategies designed to reach the most profitable customers and improve revenue generation. This paper presents an alternative approach, in which patient needs are matched with a production logic derived from the medical knowledge needed to manage the health problem, and patients’ willingness and ability to self-manage and co-produce services. Seven segments are identified: Healthy persons; persons with incidental needs; persons with chronic conditions; persons with multiple health problems and illnesses (often elderly); persons needing precise elective interventions; persons needing qualified accident and emergency services; and tertiary care patients. Designing care to suit these patient segments will use resources more efficiently, with better prospects of favourable medical outcomes, a higher service quality, less complications and improved patient safety.