Identifying high-users of medical care in a farming-dependent county.

In the future, demand management will be required of health care organizations that become at-risk for the cost of care. Methods for identifying market segments composed of high users need to be adopted and routinely employed. The study reported here is an example of such an effort. Physician visits in a farming-dependent county in the upper-middle west were assessed via postal questionnaire in this study. A 15-percent random sample of households yielded 327 surveys. The frail elderly, low-income elderly, low-income adults, and recently hospitalized middle-aged and elderly persons were identified as market segments disproportionately composed of high users. Demand management programs might fruitfully be targeted at these groups. Judicious clinic expansions might reduce medical office visits.