ArticleFrontiers in public health2020
Modeling Patient Journeys for Demand Segments in Chronic Care, With an Illustration to Type 2 Diabetes.
Article in Frontiers in public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: a Concept analysis and systematic review.BMC health services research · 2022Pooled it
- The effectiveness, equity and explainability of health service resource allocation-with applications in kidney transplantation & family planning.Frontiers in health services · 2025Article
- Learning Care Pathways Framework: A New Method to Implement, Learn, Replicate, and Scale up Care Pathways for and With the Patient.International journal of health policy and management · 2025Article
- Through the eyes of the patients: a qualitative study of diabetes patients' experiences navigating the healthcare system.Frontiers in endocrinology · 2025Article
- Benefits and limitations of business process model notation in modelling patient healthcare trajectory: a scoping review protocol.BMJ open · 2022Article
- Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran.BMC health services research · 2021Article
- Journey Through Healthcare of People With Complications of Type 2 Diabetes: A Qualitative Study of Lived Experiences.International journal of integrated careArticle
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Authors and funding
4 authors at 1 institution in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chronic care is an important area for cost-effective and efficient health service delivery. Matching demand and services for chronic care is not easy as patients may have different needs in different stages of the disease. More insight is needed into the complete patient journey to do justice to the services required in each stage of the disease, to the different experiences of patients in each part of the journey, and to outcomes in each stage. With patient journey we refer to the "journey" of the patient along the services received within a demand segment of chronic care. We developed a generic framework for describing patient journeys and provider networks, based on an extension of the well-known model of Donabedian, to relate demand, services, resources, behavior, and outcomes. We also developed a generic operational model for the detailed modeling of services and resources, allowing for insight into costs. The generic operational model can be tailored to the specific characteristics of patient groups. We applied this modeling approach to type 2 diabetes (T2D) patients. Diabetes care is a form of chronic care for patients suffering diabetes mellitus. We studied the performance of T2D networks, using a descriptive model template. To identify and describe demand we made use of the following demand segments within the diabetes type 2 population: patients targeted for prevention; patients with stage 1 diabetes treated by their GP with lifestyle advice; patients with diabetes stage 2 treated by their GP with lifestyle advice and oral medication; patients with stage 3 diabetes treated by their GP with lifestyle advice, oral medication, and insulin injections; patients with stage 4 diabetes with complications (treated by internal medicine specialists). We used a Markov model to describe the transitions between the different health states. The model enables the patient journey through the health care system for cohorts of newly diagnosed T2D patients to be described, and to make a projection of the resource requirements of the different demand segments over the years. We illustrate our approach with a case study on a T2D care network in The Netherlands and reflect on the role of demand segmentation to analyse the case study results, with the objective of improving the T2D service delivery.
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