Clustering users of healthcare, social and employment services: a register study from Finland

BACKGROUND: Understanding the population's overall use of healthcare, social and employment services is important for comprehending service needs and improving the coordination of services. The aim of this exploratory study was to find separate groups in a working-age population based on individuals’ use of various healthcare, social and employment services during one year and to investigate sociodemographic and health-related predictors of user groups. METHODS: Administrative register data on the use of 22 distinct healthcare, social and employment services and on socio-demographic and health-related covariates from year 2018 were linked for all working-age residents of the municipality of Oulu, Finland (N = 119,740). K-means cluster analysis was used to group the study subjects into clusters, based on their yearly frequency of using each service. Multinomial logistic regression was used to assess the associations of sociodemographic and health-related covariates with cluster assignment. RESULTS: Five distinct clusters were identified, labelled ‘low to moderate users of healthcare’ (82%), ‘regular employment services users with moderate use of healthcare’ (10%), ‘supported employment services users’ (3%), ‘frequent users of healthcare, social and employment services’ (3%) and ‘disability and specialized services users’ (3%). Each cluster showed different patterns of service use and was also uniquely associated with sociodemographic and health-related covariates, reflecting distinct service user types. CONCLUSIONS: The study identified five distinct groups of healthcare, social and employment services users in a working-age population. Knowledge of different user profiles and their determinants can help predict future need and use of services, coordinate and integrate services, and plan early interventions and prevention measures. This is important in order to save costs and improve the overall quality and effectiveness of services for groups with different care needs. KEY MESSAGES: • In terms of their use of healthcare, social and employment services, the working-age population can be classified into distinct groups, uniquely associated with various determinants. • Understanding the population’s use of different services can help predict future needs and improve coordination, integration and effectiveness of services in groups with different needs.