Market segmentation

Health Progress, Mar/Apr 2002 by Zuckerman, Alan M, Johnson, Tracy K

Sensitivity to cultural issues that may be barriers to accessing health care can lead to the development of programs that increase access, improve health status, and increase patient satisfaction. Bilingual staff and even multilingual translation services in very diverse communities are an important first step in reaching out to these markets. In many Arabic and Asian communities, women must be chaperoned by male relatives to see health professionals. An obstetric health clinic at St. Joseph's Hospital in Paterson, NJ, expanded its hours into the evening so that husbands could bring their wives for care after working hours.

Programs that modify the delivery of care to meet cultural and religious needs can also enhance services and revenues. "Bloodless medicine" programs have been successful in communities with a significant population of Jehovah's Witnesses and other religious groups whose beliefs forbid blood transfusions.

DISEASE CATEGORIES

Segmenting the market by disease can be another useful way to identify gaps in the delivery of care and to enhance services and revenues. Unlike the service continuum concept (discussed in an earlier article, "Filling Gaps in the Continuum," November-December 2001, pp. 34-38), which starts with the question "What are all the diagnostic and treatment services we can offer in a clinical specialty area, such as cardiology?" segmenting the market by disease asks, "What services are needed by those with a certain condition or disorder?" This approach starts with a comprehensive review of the patient's needs and may cross traditional service lines.

A community assessment of key health status indicators in the service area and review of highvolume diagnoses admitted or treated at the health system are good ways to identify health conditions and disorders that may warrant more focused attention. Typically, conditions related to an aging population-such as diabetes, arthritis, neurological conditions, heart disease, and pulmonary disease-are found frequently in patients accessing health services. In some areas, asthma, particularly in children, is a significant health issue.

Once the major health issues in the population are confirmed, an inventory of services potentially needed by patients with specified conditions can be prepared and compared with existing capabilities to identifiy gaps in services. If the service area has a high incidence of diabetes, a comprehensive diabetes program can provide the entry point to multiple services, including assessments, education, weight management, laboratory services, vascular studies, wound care, and surgery. An arthritis program targeted to older residents can coordinate patient services, including assessments, imaging, pain management, physical/occupational therapy, joint replacement, and clinical trials.

Neurologic institutes can provide an umbrella for a number of conditions, including strokes, Parkinson's disease, Alzheimer's disease, multiple sclerosis, epilepsy, balance disorders, and sleep disorders. As discussed in a previous article in this series ("Niche Services," January-February 2001, pp. 23-28, 51), the aging of the U.S. population, advances in technology, increasing subspecialization, and higher levels of research funding are fueling interest and service development in the neurosciences. Although some capabilities will remain only in academic medical centers that provide the most comprehensive array of services, many subspecialty neurology programs are becoming increasingly feasible for community hospitals because of growing volumes and the diffusion of technology to lower-cost settings. Community hospitals serving populations of 250,000 or more should be able to sustain a fairly comprehensive neuroscience program. A population of this size can generate 1,200 neurology-- related discharges, nearly 1,000 neurosurgical procedures, and more than 2,500 neurodiagnostic procedures for a variety of conditions.6