ArticleBMC health services research2017
Evaluation of a practical expert defined approach to patient population segmentation: a case study in Singapore.
Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Mapping Healthcare Needs: A Systematic Review of Population Stratification Tools.Medical sciences (Basel, Switzerland) · 2025Pooled it
- Population segmentation based on healthcare needs: a systematic review.Systematic reviews · 2019Pooled it
- Utilisation of Electronic Health Records for Public Health in Asia: A Review of Success Factors and Potential Challenges.BioMed research international · 2019Pooled it
- Systemic Population Segmentation Based on the Unified Care Model: An Approach to Health System Transformation.Healthcare (Basel, Switzerland) · 2025Article
- Development and validation of the Health Segment Classification of Population Encompassed within Singapore (HealthSCOPES) framework.PloS one · 2025Article
- Article
- Segmentation and shielding of the most vulnerable members of the population as elements of an exit strategy from COVID-19 lockdown.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2021Article
- Can cluster analyses of linked healthcare data identify unique population segments in a general practice-registered population?BMC public health · 2020Article
- Article
- Identifying optimal indicators and purposes of population segmentation through engagement of key stakeholders: a qualitative study.Health research policy and systems · 2020Article
- Identifying subgroups of high-need, high-cost, chronically ill patients in primary care: A latent class analysis.PloS one · 2020Article
- Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country.JAMA network open · 2019Article
- Predictive ability of an expert-defined population segmentation framework for healthcare utilization and mortality - a retrospective cohort study.BMC health services research · 2019Article
- Identifying heterogeneous health profiles of primary care utilizers and their differential healthcare utilization and mortality - a retrospective cohort study.BMC family practice · 2019Article
- Outpatient primary and tertiary healthcare utilisation among public rental housing residents in Singapore.BMC health services research · 2019Article
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6 authors.
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Abstract
backgroundSegmenting the population into groups that are relatively homogeneous in healthcare characteristics or needs is crucial to facilitate integrated care and resource planning. We aimed to evaluate the feasibility of segmenting the population into discrete, non-overlapping groups using a practical expert and literature driven approach. We hypothesized that this approach is feasible utilizing the electronic health record (EHR) in SingHealth.
methodsIn addition to well-defined segments of "Mostly healthy", "Serious acute illness but curable" and "End of life" segments that are also present in the Ministry of Health Singapore framework, patients with chronic diseases were segmented into "Stable chronic disease", "Complex chronic diseases without frequent hospital admissions", and "Complex chronic diseases with frequent hospital admissions". Using the electronic health record (EHR), we applied this framework to all adult patients who had a healthcare encounter in the Singapore Health Services Regional Health System in 2012. ICD-9, 10 and polyclinic codes were used to define chronic diseases with a comprehensive look-back period of 5 years. Outcomes (hospital admissions, emergency attendances, specialist outpatient clinic attendances and mortality) were analyzed for years 2012 to 2015.
resultsEight hundred twenty five thousand eight hundred seventy four patients were included in this study with the majority being healthy without chronic diseases. The most common chronic disease was hypertension. Patients with "complex chronic disease" with frequent hospital admissions segment represented 0.6% of the eligible population, but accounted for the highest hospital admissions (4.33 ± 2.12 admissions; p < 0.001) and emergency attendances (ED) (3.21 ± 3.16 ED visits; p < 0.001) per patient, and a high mortality rate (16%). Patients with metastatic disease accounted for the highest specialist outpatient clinic attendances (27.48 ± 23.68 visits; p < 0.001) per patient despite their relatively shorter course of illness and high one-year mortality rate (33%).
conclusionThis practical segmentation framework can potentially distinguish among groups of patients, and highlighted the high disease burden of patients with chronic diseases. Further research to validate this approach of population segmentation is needed.
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