Health care fails to recognize its customer profiles
Health care fails to recognize
its customer profiles
In public debate, users of health care services are usually roughly divided into those using public health care and those using private health care – or into patients and customers. However the issue is in fact much more complex. From a culture theoretical perspective, we can distinguish five different groups each of which has their own approach to using and also evaluating health care services. If we could recognize these groups and tailor services accordingly, it would benefit both patients and budget-makers.
Individualist, hierarchist or fatalist?
Jari Vuori, Professor at the University of Eastern Finland, discussed different user groups and their significance at the Laboratory Medicine event.
Vuori describes the first group as being autonomous actors, who are very independent in looking after their wellbeing and are especially eager to use electronic services. They should also be provided with this type of services, Vuori says.
– They will handle matters for themselves, if we just provide them with the tools. This would also free up resources, which are limited as it is, to take care of these other groups.
Individualists, on the other hand, follow their consumer needs. They use private services and often consider health, wellbeing and looking good as being one and the same thing.
The majority of Finns are probably hierarchists. They rely on the authorities – in other words, doctors – and primarily use public health care services, because that is the way it has always been done.
–– If we could direct even half of these people somewhere else, we would see an enormous decrease in costs. This could be made possible through case management. Some matters could be dealt with by different communities instead of health care units.
Like autonomists, egalitarians are also very active in maintaining their wellbeing. They prefer to rely on their family or some other community and value a sense of community as being the most important factor in services as well.
The last group comprises fatalists, who are indifferent to their health and do not seek services until they absolutely have to.
– They consider their health – and death – to be their own business. If and when they end up facing treatment, it will be costly.
Freedom of choice does not guarantee good health
The freedom to choose between different health care service providers has been much praised in Finland in recent years. According to Jari Vuori, this freedom is, however, often only apparent and can even be dangerous in some cases.
– The lower the level of education, the more likely a person is to make an appointment with a masseur instead of a physician. In other words, not seek help where they could receive health care.
Vuori considers especially risky a situation where individualists start picking services according to their personal preferences.
– This can lead to the Brazilian approach, where you can get a nose job through public health care services but have to pay for a mammography.
According to studies conducted in OECD countries, an unlimited freedom of choice increases happiness but not health. Few are able to pick the right service provider despite the unlimited choice.
– Could you? Vuori asked the audience at the Laboratory Medicine event.
– If you were diagnosed with cancer, how many of you would know how to choose an appropriate place for treatment? As citizens, we simply do not know enough to make an informed decision on the best possible treatment for ourselves.
Health care professionals are not any better either.
– It has been shown that the most non-resourceful people when making decisions like this are physicians and nurses themselves. At the time of emergency, the mind goes blank. That is why there should be some kind of guidance in place for making these choices.
Health centres on wheels
Freedom of choice is also made more difficult by limited resources. Vuori has a clear vision of where savings could be made.
– We do not need so many health centres in rural areas, popping up in the middle of nowhere. Health centres should be put on wheels instead.
According to Vuori, such mobile clinics could serve as local village meeting points like health centre waiting rooms and mobile libraries do now. They could create a sense of community and encourage elderly people to look after themselves better, for example.
– This requires the utmost competence and careful planning, though, Vuori points out.
Tailored service through profiling
Vuori says that we should now start analysing different customer profiles within health care to identify different user groups and their needs. While people cannot find a service profile to suit their needs, their ability to look after their health is reduced, leading to ever increasing costs.
– The best option would be for everyone to be able to use exactly the type of services that would be best suited to promoting their health, whether it be private, public, electronic or something else.
Profiling would also help to identify the “outsiders”, i.e. those fatalists, who do not seek treatment on their own but who should however be reached before they end up facing expensive treatment with multiple chronic conditions.
Text and photo: Hanna Hyvärinen
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