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基于人群的医学中患者不同需求和期望的分析:使用分割分析的案例研究。

Profiling the different needs and expectations of patients for population-based medicine: a case study using segmentation analysis.

机构信息

Department of Policy Analysis and Public Management, Cergas and Area PMP SDA Bocconi, Bocconi University, Via Rontgen 1, 20136, Milan, Italy.

出版信息

BMC Health Serv Res. 2012 Dec 21;12:473. doi: 10.1186/1472-6963-12-473.

Abstract

BACKGROUND

This study illustrates an evidence-based method for the segmentation analysis of patients that could greatly improve the approach to population-based medicine, by filling a gap in the empirical analysis of this topic. Segmentation facilitates individual patient care in the context of the culture, health status, and the health needs of the entire population to which that patient belongs. Because many health systems are engaged in developing better chronic care management initiatives, patient profiles are critical to understanding whether some patients can move toward effective self-management and can play a central role in determining their own care, which fosters a sense of responsibility for their own health. A review of the literature on patient segmentation provided the background for this research.

METHOD

First, we conducted a literature review on patient satisfaction and segmentation to build a survey. Then, we performed 3,461 surveys of outpatient services users. The key structures on which the subjects' perception of outpatient services was based were extrapolated using principal component factor analysis with varimax rotation. After the factor analysis, segmentation was performed through cluster analysis to better analyze the influence of individual attitudes on the results.

RESULTS

Four segments were identified through factor and cluster analysis: the "unpretentious," the "informed and supported," the "experts" and the "advanced" patients. Their policies and managerial implications are outlined.

CONCLUSIONS

With this research, we provide the following: - a method for profiling patients based on common patient satisfaction surveys that is easily replicable in all health systems and contexts;- a proposal for segments based on the results of a broad-based analysis conducted in the Italian National Health System (INHS).Segments represent profiles of patients requiring different strategies for delivering health services. Their knowledge and analysis might support an effort to build an effective population-based medicine approach.

摘要

背景

本研究通过填补该主题实证分析中的空白,展示了一种针对患者细分分析的循证方法,这将极大地改善基于人群的医学方法。细分有助于在文化、健康状况和患者所属人群的健康需求背景下为个体患者提供护理。由于许多卫生系统都在制定更好的慢性病管理举措,患者特征对于了解某些患者是否能够转向有效的自我管理至关重要,这也可以在确定患者自身护理方面发挥核心作用,从而增强他们对自身健康的责任感。对患者细分的文献综述为这项研究提供了背景。

方法

首先,我们对患者满意度和细分进行了文献回顾,以构建调查。然后,我们对门诊服务用户进行了 3461 次调查。使用主成分因子分析和方差极大旋转提取了基于受访者对门诊服务感知的关键结构。在因子分析之后,通过聚类分析进行细分,以更好地分析个体态度对结果的影响。

结果

通过因子和聚类分析确定了四个细分群体:“不挑剔的”、“知情并得到支持的”、“专家”和“先进的”患者。概述了它们的政策和管理意义。

结论

通过这项研究,我们提供了以下内容:- 一种基于常见患者满意度调查的患者特征分析方法,易于在所有卫生系统和环境中复制;- 根据在意大利国家卫生系统(INHS)中进行的广泛分析结果提出的细分建议。细分代表了需要不同医疗服务提供策略的患者群体。他们的知识和分析可能有助于建立有效的基于人群的医学方法。

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