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Validation and application of a needs-based segmentation tool for cross-country comparisons
Lize Duminy1,2, Nirmali Ruth Sivapragasam3, David Bruce Matchar3,4
1Institute for Health Policy and Health Economics, Bern University of Applied Sciences, Bern, Switzerland.
Health Services Research
|November 10, 2021
Summary
A new tool, the Cross-Country Simple Segmentation Tool (CCSST), segments populations by health needs. It reveals significant cross-country variations in healthcare needs, with Poland having the highest and Switzerland the lowest.
Area of Science:
- Gerontology and Public Health
- Health Services Research
- Comparative Health Systems Analysis
Background:
- Comparing healthcare needs across countries is complex.
- Existing methods lack a standardized approach for population segmentation based on health and social service needs.
- Understanding these variations is crucial for effective health policy and resource allocation.
Purpose of the Study:
- To develop and validate a novel tool for segmenting populations into distinct, needs-based health states for cross-country comparisons.
- To assess and compare the distribution of health needs across European countries using the developed tool.
- To analyze transitions between health states and mortality risk to identify country-specific factors.
Main Methods:
- Development of the Cross-Country Simple Segmentation Tool (CCSST), a clinician-administered instrument.
- Categorization of individuals into 1-5 global impression (GI) segments and assessment for 4 complicating factors (CFs) using clinical indicators, diagnoses, and performance tests.
- Analysis of Survey of Health, Aging and Retirement in Europe (SHARE) panel data from 13 countries (270,208 observations).
- Use of Cox proportional hazard models to estimate mortality risk by segment and analyze transitions between health states.
Main Results:
- The CCSST effectively segmented the population into needs-based health states.
- Significant cross-country differences were observed: Switzerland, Denmark, and Sweden had the lowest proportion of individuals in high medical needs segments, while Poland, Italy, and Israel had the highest.
- Hazard ratios for transitioning between health states varied, suggesting potential for identifying country-specific risk factors.
Conclusions:
- The CCSST is a validated and innovative tool for comparing health needs and transitions across countries.
- It provides policymakers with a method to compare national health system performance.
- The tool offers targeted guidance for identifying strategies to manage high-need, high-cost patient populations.
Keywords:
access/demand/utilization of serviceschronic diseasecomparative health systems/international healthgeriatricshealth care organizations and systemsintegrated delivery systemsmodeling: multi-levelsurvey research and questionnaire designMore Related Videos
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