title: Using archetypes to design services for high users of healthcare.
abstract: A subset of people with complex health and social needs account for the majority of healthcare costs in Ontario. There is broad agreement that better solutions for these patients could lead to better health outcomes and lower costs, but we have few tools to design services around their diverse needs. Predictive modelling may help determine numbers of high users, but design methods such as user archetypes may offer important ways of understanding how to meet their needs. We studied a range of patient profiles and interviews with frequent emergency department users to develop four archetypes of patients with complex needs to orient the service design process. These can be refined and adapted for use within initiatives like Health Links to help provide more appropriate cost-effective care.
authors.affiliation: Samuel Vaillancourt, MD CM,MPH, FRCP(C), Department of Emergency Medicine and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON.
authors.forename: Samuel
authors.initials: S
authors.lastname: Vaillancourt
authors.affiliation: Fellow, Incubator@WIHV, Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Toronto, ON.
authors.forename: Ilan
authors.initials: I
authors.lastname: Shahin
authors.affiliation: Fellow, Incubator@WIHV, Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Toronto, ON.
authors.forename: Payal
authors.initials: P
authors.lastname: Aggarwal
authors.affiliation: Fellow, Incubator@WIHV, Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Toronto, ON.
authors.forename: Steve
authors.initials: S
authors.lastname: Pomedli
authors.affiliation: Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Toronto, ON.
authors.forename: Leigh
authors.initials: L
authors.lastname: Hayden
authors.affiliation: Department of Medicine, Women's College Hospital, Toronto, ON.
authors.forename: Laura
authors.initials: L
authors.lastname: Pus
authors.affiliation: Onil Bhattacharyya, MD, PhD, Frigon Blau Chair in Family Medicine Research Women's College Hospital, Associate Professor, Department of Family and Community Medicine, Associate Professor, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON.
authors.forename: Onil
authors.initials: O
authors.lastname: Bhattacharyya
mesh_terms: D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care; D004636:Emergency Service, Hospital; D017048:Health Care Costs; D006301:Health Services Needs and Demand; D006801:Humans