Abstract / Summary
Patient segmentation aims at recognizing groups of patients with similar needs in health care. Targeting appropriate services and care resources to each group reduces care costs. Navigator is a Finnish patient segmentation service based on questionnaires for patients and professionals. Navigator considers the patient’s individual values and functional ability, and therefore this service may supplement data-based segmentation methods. Knowledge concerning Navigator’s validity is lacking. Nurses ( n = 16) used Navigator with diabetic patients ( n = 304) at a health center. We performed an exploratory factor analysis (EFA) of Navigator’s data, and we derived factor scores to test hypotheses of smaller differences between the genders and greater differences between younger (< 75 years) and older (≥ 75 years) groups when responding to Navigator (construct validity). We correlated (using Spearman’s rho) Navigator’s dimension of the patient’s ability to function with measures of disability (WHODAS 2.0), self-rated health (SRH), health-related well-being (EQ-VAS), and general well-being (WBQ-12), as well as the dimension of the patient’s health status with patient-reported chronic conditions, all medication and diabetes care values (glycated hemoglobin (HbA1c), urine albumin-creatinine ratio (UACR), low-density lipoprotein (LDL), blood pressure (BP), smoking, and body-mass index (BMI). Both EFAs were successful as we identified the “patient’s mood” and “patient’s enablement” factors in the patient’s questionnaire, and the “fulfilling care” and “patient’s health status” factors in the professional’s questionnaire. Significant differences in most factor scores emerged in the comparison of age groups. Significant correlations were noticed between the patient questions and WHODAS 2.0 ( p < 0.001), SRH ( p < 0.001), EQ-VAS ( p < 0.001), and WBQ-12 ( p < 0.001), as well as between the professional questions and the number of chronic conditions ( p < 0.001), all medication ( p < 0.001), HbA1c ( p < 0.001), UACR ( p < 0.001), smoking ( p < 0.044), and BMI ( p < 0.027). The factors successfully identified in the EFAs support the dimensions of Navigator. It also differentiated between people on the basis of age when the features of patient enablement, fulfilling care, and health status were considered. In respect of these appropriate construct validity results and preferable concurrent validity, Navigator seems to be valid in measuring the dimensions of patients’ coping in everyday life and health status. Therefore, Navigator may supplement data-based patient segmentation by adding to the understanding of individuals in patient groups.