Effective Segmentation of the U.S. Aging Population to Improve the Delivery of Preventive Health Services

The purpose of this study was to investigate demographic and other risk factors related to timely receipt of preventive care, and to identify different segments of the population who most need improved access to preventive health services. We used decision tree modeling to combine relevant risk factors and create distinct segments of the population who were below national average rates in receiving preventive care in a timely manner. Data were collected from the 2009 Medical Expenditure Panel Survey (MEPS) Household Component. We selected three preventive health services for analysis: dental checkup, mammogram, and routine health checkup. Criteria for target populations and frequency of use of such services were determined based on guidelines developed by the U.S. Preventive Health Task Force (e.g., biennial screening mammography for women aged 50 to 74 years). We examined demographic and other characteristics as risk factors including age, gender, race, income, education, insurance, marital status, health status, residential area. We developed several decision trees with different number of nodes for an aging population by manipulating training parameters in order to identify most meaningful and useful population subgroups. The results of this study indicated that the timely receipt of preventive care among adults was significantly influenced by particular sets of demographic and other characteristics that could define specific segments of the population in need of more timely access to preventive care. A better understanding of these findings would enable us to prioritize our efforts in enhancing aging populations' access to health care and improving public health outcomes.