Segmentation of the healthcare services market. Degree work marketing approaches to pricing for medical services. Segmentation of the medical services market by main competitors

25.11.2019

Milovanova Natalya Vladimirovna, Chief Specialist of the Insured Relations Department / Territorial Compulsory Medical Insurance Fund of the Volgograd Region; Applicant for the degree of Candidate of Economic Sciences of the Department of World Economy and economic theory» Volgograd State Technical University, Russia

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The most important marketing tool used to improve the efficiency of medical organizations, is market segmentation. It will help determine what medical services should be provided, in what quantity, which groups of patients need them, what are the advantages and disadvantages of the organization in relation to its competitors.

JEL classification:

The most importanta marketing tool used to improve the efficiency of the functioning of medical organizations is market segmentation. It will help determine what medical services should be provided, in what quantity, which groups of patients need them, what are the advantages and disadvantages of the organization in relation to its competitors.

Market segment medical services- this is a selected part of the market, any of the groups of patients, services or medical institutions that have common features. Patients can be grouped by geographic or demographic characteristics, income level, professions, outlook on life, etc. It is important for a medical institution which of the possible objects and signs of grouping is most needed today or will be needed tomorrow for the implementation of services. Practice marketing activities shows that segmentation is one of the most important tools that ensure the success of a medical organization.

Segmentation is based on the following criteria:

1. Quantitative parameters of the segment - the volume of medical services that can be provided; number of potential patients; the territory in which they live, etc.;

2. Availability of the segment for a medical institution - the availability of opportunities to receive channels for promoting services;

3. Segment materiality - determining how realistic a particular group of patients can be considered as a market segment, how stable it is in terms of the main unifying features;

4. Profitability - with the help of this criterion, they determine how profitable the work in the selected market segment will be;

5. Compatibility of the segment with the market of the main competitors. This criterion will help answer the question to what extent the main competitors are willing to give up their chosen market segment;

6. Security of the selected segment from competitors. In accordance with this criterion, it is determined who can become a potential competitor, what are its strengths and weak sides whether there are advantages to the medical institution and what they are.

Having determined the above criteria, one can decide whether or not this segment is suitable for the organization, whether it is worth continuing to study consumer demand for the services provided, collect information and invest additional funds.

Patients differ from each other in a variety of ways. As a basis for segmentation, you can use any of them: demographic, geographic, psychographic (behavioral). Analysis can be carried out for each feature and then in combination with each other.

Geographical segmentation involves the breakdown of the market into countries, regions, regions, cities, districts. Geographic features include:

- the size of the area;

- population size and density;

- remoteness of the medical institution from the city center;

- transport network of the region.

As part of demographic segmentation, it is necessary to divide patients into several age categories: children, adolescents, adults and the elderly. You can make an even more detailed division by indicating age intervals.

The level of education can also be used to identify market segments. Poorly educated patients spend less time reading newspapers and magazines that provide information about the provision of medical services, while educated patients can compare and choose those that they consider to be the most preferable.

The level of income is one of the most significant features. It allows you to identify groups of patients with low, medium and high earnings. Because each category has different in cash, this affects their ability to receive medical services at a price corresponding to their income.

Segmentation by occupation can also influence a patient's choice of attending a particular health facility. People with more complex, responsible or prestigious professions prefer to choose an organization with a comfortable environment, a high level of qualification of doctors, etc.

Mention should also be made of such indicators as marital status and family size. . For example, having multiple children undoubtedly increases the demand for pediatric doctors; elderly family members need a range of health services usually provided at this age.

Psychographic segmentation helps to identify such characteristics as lifestyle, personality type and interests of patients, as well as characterize the possible response to the offered medical services. The experience of Western countries shows that representatives of all business areas strive to analyze the lives of their clients in as much detail as possible: many companies, including clinics, have special departments for this.

The lifestyle of patients determines how people live, how they spend time and money. It is clear that high-income patients will go to the best (or trendy) facilities that best suit their lifestyle, and the low-income category will act on their ideas.

The medical services market is represented by various combinations of patient groups. Having properly studied all segments, it is possible to determine which groups the clinic will predominantly work with.

When developing a marketing strategy for a medical institution, it is necessary to highlight the characteristics of the patients it will serve. What you need to know about patients :

- who is the patient at the moment, and who can become one in the future;

– what are the needs and wishes of patients;

- what are the motives for applying to a particular medical institution for the provision of services;

– what unmet needs do patients have at the time of visiting a doctor, what would they like to change, etc.

This information can be an important source of ideas for the further development of the organization's strategy.

It is necessary to introduce the practice of maintaining patient records in every medical institution . Usually in polyclinics there is only a medical record of an outpatient, in which of all the above signs are reflected: last name, first name, patronymic; date of birth: address and phone number; profession . When customizing, you can use the following features:

- the age of patients and their distribution into groups (for example, up to 15, 15-25, 26-40; 41-55, over 55 years old);

- the ratio of men and women among patients;

- place of residence;

- the average level of income of patients;

– level of education, social status, occupation;

– lifestyle (interests, views);

- frequency of contacting a medical institution (often, periodically, rarely, for the first time);

- motives for applying to a medical institution (necessity, chance, desire to demonstrate one's wealth or position, etc.);

- which medical institutions had to be contacted earlier, what advantages and disadvantages of service were noticed by the patient in their work.

Such a list must be maintained and detailed by creating an electronic database of patients. Each medical institution should be interested in identifying its specific consumers and finding all possible ways to keep patient adherence.

The need of people for medical care is high as in no other area. In this regard, medical institutions are obliged to use in their activities latest developments in marketing. Segmentation of the medical services market, as one of the marketing tools, is of great practical importance. Its competent and consistent application orients the medical institution to the choice of the most profitable strategy in economic and social terms.

Adaptation of traditional healthcare systems to the conditions of market relations, research of medical medical activity from the point of view of production and sale of medical services, disclosure of the effect of economic laws in the organization and implementation of the treatment and diagnostic process - objective realities modern stage medicine at the end of the 20th century.

Despite modern technocratic approaches to assessing medical performance and considering healthcare systems as one of the manufacturing sectors state economy - at the heart of the methods and techniques of healing, as in the past, there are manifestations of fundamental contradictions in the relationship between the human body and the environment.

It is the factors external environment and the internal state of a person give rise to a certain range of needs and lead to the formation of a system of appropriate proposals to meet the needs.

As is known, social significance Personal health problems can be viewed from a variety of perspectives, the three main ones being:

mortality;
loss of health and disability (illness, temporary and permanent disability);
restriction of the freedom of the individual's life activity (loss of "quality of life").

In accordance with these conditional levels of medical and social problems, the individual has a feeling of lack of something: the ability to live, work, be healthy, etc. Such feelings in marketing systems are characterized by the term “need” and, in accordance with the individuality and cultural level of the individual, give rise to certain individual or collective needs.

Specific medical needs lead to the need for medical care, some of these needs, acquiring the marketing essence of demand, generate a health market with its target functions and corresponding medical offers and actions.

Human needs, conventionally referred to as medical, can be legitimately correlated with the three positions indicated above.

With this approach, three groups (complexes) of basic needs and needs, one way or another related to the need to purchase medical services, are distinguished:

the need to live;
the need to be healthy while maintaining working capacity:
a - the desire to return to normal in case of temporary disability,
b - the desire to maintain a certain "niche" of working capacity in the presence of disability;
the need for the highest degree of freedom of life (physiological, psychosomatic, social), i.e. in this case, the state of need is characterized by the desire to achieve the highest degree of "quality of life".

The above logic allows us to outline the boundaries of a kind of socio-economic field of the relationship between the patient and the doctor, in other words, to designate, although conditional, but quite definite boundaries of the medical services market and, within these boundaries, it is natural to correlate natural human needs and needs with the categories of the healthcare marketing system.

That is, the medical services market can be logically divided into segments.

Thus, in the system of medical marketing (offers of medical care) at the highest level of segmentation of the medical services market, it is legitimate to single out three main areas with specific forms of offering medical services and meeting medical needs (it is clear that the boundaries between these market segments are to a certain extent conditional) .

Medical offers of medical services for the preservation of life. Let's conditionally call this segment of the health market - "the marketing segment of life."
Medical offers of medical services for the purpose of restoring health, restoring and maintaining a certain level of ability to work in case of its temporary loss. Detailing the types of medical services in this segment is carried out in the following areas: a) medical services aimed at treating acute and preventing exacerbations of chronic diseases; b) medical services aimed at preventing the transfer of temporary disability into permanent disability (disability); c) medical services for the preservation and maintenance of a certain degree of chronic conditions and disabilities. We will conditionally call this segment of the health market the “marketing segment of diseases”
Medical services that preserve and maintain the state of a relatively healthy body (immune prophylaxis, clinical examination, etc.). We will characterize this segment as the “health marketing segment”.

Based on such a methodological approach, it seems rational to correlate, on the one hand, a certain segment of the market with the specific functions of medical (medical) work, on the other hand, to characterize these functions not only from the point of view of the humanitarian mission of health care (doctoring), but also set of medical services economic characteristics corresponding to a specific market segment. Such segmentation of the health market seems to be justified precisely from the point of view of economic feasibility, a certain unification and, in particular, a prospective calculation of the profitability of medical medical activity,

Thus, when providing medical services aimed at saving the patient's life, the humanitarian mission of healthcare and the ethical side of medical activity in modern society far superior to economic feasibility. While any activity must be expressed economic characteristics if this activity is considered within the framework of a marketing relationship. It is in this segment of the market that the contradictions of the entities defined by the categories “medical care” and “medical service” are noticeably exposed.

The search for the resolution of objective internal contradictions between these categories leads some authors, it would seem, to a logical conclusion: a medical service is subject to payment, and not medical care. And within the framework of measures to provide medical care, losses incurred as a result of a combination of certain medical (medical) actions are subject to compensation. In our opinion, such a methodological approach is fundamentally erroneous. Firstly, in this case, it will be necessary to distinguish in detail the types of medical activity into medical care and medical services, which is not always unambiguous, and one of the criteria for the difference is to determine the economic component, i.e., apparently, initially do not correlate the category "medical care" with marketing characteristics, which immediately eliminates the market contradictions of these categories. Secondly, with the obligatory objective decision of the economic side of the provision of medical care in the form of compensation for material and resource losses, it will be impossible to determine by any qualimetric criteria the necessity and sufficiency of this particular volume of medical procedures. With this approach competitive advantages types and methods of medical care are fundamentally excluded. Thus, the category "medical care" can only be considered legitimately outside the framework of the marketing relationship between the doctor and the patient, as soon as these relationships are transferred to the market field, other laws begin to operate under which such elements of the marketing system as meeting the needs and demand of the patient (client) medical offers of medical services and medical actions in the form of medical procedures universally and unambiguously characterize the target functions of the health market.

It must be unambiguously recognized that there is no place in healthcare marketing systems for such a concept as medical care, but there is an element of the market - a medical service. Medical care is a category of non-market relations between a doctor and a patient. At best, a certain set of medical services and other elements of the marketing system adequate to them can be generally characterized as medical care.

When providing medical services in the marketing segment of diseases, in which the needs and demand for medical procedures are determined by temporary needs in case of deviations in the psychosomatic state of the client (disease), economic factors begin to play their role. The task of researchers is to characterize this market essence medical care, justify the place, degree of influence and predominance of factors of marketing relationships in the system of other elements that characterize the "non-market" relationship between the doctor and the patient.

Finally, medical services aimed at meeting the needs of improving the "quality of life" in a modern civilized society in the health market can be characterized a high degree profitability. AT modern conditions, the structure of the tariff for such medical services, in essence, should include the economic costs of producing medical services, which are possible in two other segments of the health market - “ marketing segment life” and “disease marketing segment”. In addition, the full satisfaction of the needs of consumers in this segment of the health market, to a greater extent, is not associated with medical medical activity, but is determined by other individual, natural and socio-economic factors.

The proposed approach to the basics of segmentation of the health market allows, within the framework of the designated areas, to conduct further research, to study the demand for certain types of medical services in each of the segments; determine the size, growth and attractiveness of a segment in the health market according to objective criteria, using traditional medical and statistical indicators, reasonably correlating them with the economic characteristics of the doctor-patient marketing relationship.

The market consists of many types of consumers, goods, needs. The consumer market is formed by buyers who differ from each other in various parameters (place of residence, gender, age, income level, education, lifestyle, social class, etc.).

It is difficult to find a consumer with the same reaction to the proposed product or service. The marketer must understand and anticipate what influences patient behavior. When receiving various medical services, patients behave differently so it is necessary to understand how they make decisions. For example, before deciding which dental clinic it is better to apply, people look at a lot of newsletters, listen to information on radio and television, and only then choose one, the most suitable option.

Buying even the same product (service), patients are rarely guided by the same motives, although this particular product may be intended for different groups of consumers. In marketing terminology, these

consumer groups are called market segments, and the process of identifying them is called market segmentation.

Market segmentation is one of the most important marketing features that ensures the success of a medical institution. This is done in order to best meet the needs and requirements of patients and thereby ensure the sustainable functioning and profitability of the medical institution.

A segment of the market is a specially allocated part, which

or a group of patients, health care providers or medical,

having common characteristics

Segmentation is based on the following criteria:

1. Quantitative parameters of the segment - the volume of medical services that can be provided; number of potential patients; the territory in which they live, etc.

2. Availability of the segment for the medical sector, i.e. the presence of

the ability to obtain a sufficient number of channels for promoting medical services, to identify the power of these channels and their ability to ensure the implementation of the entire volume of services and medical goods - i.e. determine whether a medical institution is ready to promote its products to the market or whether something needs to be changed in its work.

3. Segment materiality - determination of how realistic this or that group of patients can be considered as a market segment and whether it is worth focusing one's activities on it.

4. Profitability - using this criterion, it is determined how profitable it will be for a medical institution to work on the basis of a selected market segment (return on invested capital, increase in profits of the institution, etc.)

5. Compatibility of the segment with the market of the main competitors - determines how the promotion of this service will affect the interests of competitors; otherwise, the medical institution may incur additional costs.

6. The security of the selected segment of the medical services market from competitors - it is determined who can become a potential competitor, what are its strengths and weaknesses, whether the medical institution has competitive advantages and what they are.

Only after receiving answers to all these questions, it is possible to decide whether or not this segment is suitable for a medical institution, whether it is worth continuing to study consumer demand for the services provided, collect information and invest additional funds.

The objects of segmentation can be patients, medical services and medical institutions. For example, patients can be grouped according to geographic or demographic characteristics, income level, professions, etc., that is, according to any of the significant characteristics. In accordance with this, the basic principles of segmentation of any consumer markets (including medical services markets) are.

The marketer must understand and anticipate what influences patient behavior. Patients behave differently when receiving different medical services, so it is necessary to understand how they make decisions. For example, before deciding which dental clinic to go to, people look through a lot of newsletters, listen to information on radio and television, and only then choose the one that suits them best. Buying even the same product (service), patients are rarely guided by the same motives, although this particular product may be intended for different consumer groups. In marketing terminology, these consumer groups are called market segments, and the process of identifying them is called market segmentation.

Market segment is a distinct part of the market, any group of patients, medical services or medical institutions having common features . Segmentation is based on the following criteria:

Quantitative parameters of the segment - the volume of medical services that can be provided; number of potential patients; the territory in which they live, etc.

Availability of the segment for a medical institution, i.e. the availability of an opportunity to obtain a sufficient number of channels for promoting medical services, to identify the power of these channels and their ability to ensure the implementation of the entire volume of services and medical products - i.e. determine whether a medical institution is ready to promote its products to the market or whether something needs to be changed in its work.

The materiality of the segment is the determination of how realistically one or another group of patients can be considered as a market segment and whether it is worth orienting one's activities towards it. Profitability - using this criterion, it is determined how profitable it will be for a medical institution to work on the basis of a selected market segment (return on invested capital, increase in the institution's profit, etc.)

Compatibility of the segment with the market of the main competitors - determines how the promotion of this service will affect the interests of competitors; otherwise, the medical institution may incur additional costs.

The security of the selected segment of the medical services market from competitors - it is determined who can become a potential competitor, what are its strengths and weaknesses, whether the medical institution has competitive advantages and what they are. Only after receiving answers to all these questions, it is possible to decide whether or not this segment is suitable for a medical institution, whether it is worth continuing to study consumer demand for the services provided, collect information and invest additional funds.

Segmentation of the medical services market by patient groups:

Geographic principle

* city, countryside

* area size

* population size and density (to determine the number of potential patients)

* climate zone

* remoteness of the medical institution from the city center

* the transport network of the area where the medical institution is located (for example, even the presence of a parking lot near the institution can increase the number of its patients)

Psychographic principle

* lifestyle and lifestyle (determine how people live, how they spend time and money; high-income patients will go to the best and most fashionable medical institutions, and the category of middle-income patients, respectively, to the most ordinary institutions)

* personality type and behavior in the market (characterizes a possible reaction to the proposed medical services, since patients can be introverts or extroverts, easily or difficultly persuasive. Introverted patients are more conservative in deciding whether to seek medical services, than extroverts; hard-to-persuade people react negatively to intense advertising and are skeptical about it, and easy-to-persuade people can be quickly persuaded to seek medical services in a particular medical institution)

* the degree of the patient's need for a particular medical service (there are 3 degrees of need - weak, medium and strong; at the same time, often those who most urgently need services, making up a relatively small group of patients, want to purchase most of the services)

* the degree of sensitivity of the patient in relation to the conditions for the provision of medical services on the market (assessed by such parameters as quality. Price, level of service, design of health facilities, attention from the doctor, etc.)

* the degree of adherence of the patient to a particular service (there may be patients who will always use the same familiar service, despite the fact that better ones will be offered, or there may be patients who easily switch from one service to another, changing your preferences)

Demographic principle

It is the basis for segmentation, because demographic traits lend themselves easily quantification and they largely explain the need for medical services:

* gender (especially important when providing gynecological, cosmetic, etc. services)

* age (if there are many elderly people in the area, this means the likelihood of an increase in the number of requests for medical care; having a large number of children means a direct increase in the need for children's medical services, etc.)

* marital status and family size (for example, having multiple children in a family increases the demand for pediatric doctors and their services)

* occupation (people with more complex, responsible or prestigious professions and specialties prefer to choose a medical institution with a comfortable environment, a high level of qualification of doctors, etc.)

* level of education (poorly educated patients spend less time reading newspapers, magazines, which provide information about the provision of medical services of a new direction, profile, while educated patients can compare and choose those services that they consider most preferable for themselves)

* income level (allows you to distinguish groups of patients with low, medium and high incomes; since each category has different funds, this affects their ability to receive medical services. As a result, prices for medical services allow you to determine which groups of patients they are designed for.

If patients mostly with an average income level apply to a medical institution, then navigate in price ratio follows them) Behavioral principle (reason for making a purchase, benefits, intensity of consumption, attitude towards advertising and product). B. Segmentation of the medical services market by main competitors The study of competitors, highlighting their strengths and weaknesses is very important for the correct development of the marketing program of a medical institution and its conquest of the market.

By comparing your services with those of your competitors, you can determine your competitive advantages and position in the market. The study of competitors begins with the collection of information about them. different ways- from advertising messages on radio, television, in print, from advertising brochures, etc. Then find out:

* which medical institutions are competitors

* what types of medical services they provide

* what prices for medical services they set

* what are the sources of funding for competitors

* what is the system for promoting medical services

* what is the number of employees (doctors and other medical staff)

* what category of patients apply to them for medical services. The assessment of competitiveness should be carried out in a complex, finding out the strengths and weaknesses of both competitors and your own. This will allow, firstly, to determine the distinctive features of competitors, and secondly, to justify their own competitive advantages - the unique, special features of a medical institution that distinguish it from others and which will help to make a profit above the average among institutions providing the same medical services.

* high reputation of the medical institution

* high quality of medical services provided

* focus on the patient, his needs and wishes

* sufficient material base (personnel, equipment, sustainable financial support).

C. Segmentation of the market according to the parameters of medical services There are usually several medical institutions in the city that offer the same services. The task of this type of segmentation is to study and highlight those features and properties of the services offered that exist on the market, that patients need and that are most preferable and necessary for them. Thus, the main goal in this case is to determine, firstly, which groups of patients are intended for these services and, secondly, which main features of the services offered are decisive for attracting patients and, therefore, increasing the competitiveness of the medical institution.

The task of marketing is precisely to achieve the maximum approximation of the volume of market demand to the capacity of the market. The most significant parameters of medical services include: the price of medical services, distribution channels, level of service

A special system of medical care was created for the leadership of the party and the country. With limited resources available for health care, some priority was given to workers and children. Even today, all this does not prevent us from asserting that the availability of qualified medical care was provided by the state, regardless of social status patient, his place of residence, etc.
The fundamental essence of the modern period of reform domestic system healthcare, along with others, is characterized by objective conditions under which a medical service becomes a commodity, and the relationship between producers and consumers of medical services (in particular, a doctor and a patient) essentially begins to be defined as marketing with a predominant role of the patient.

Classical civilized market relations, as you know, are subject to economic laws, are specific in management and are in conflict with the methods of administration. In the field of market relations, medical care, as a kind of production activities, filled with economic characteristics. Prior to that, conditional groups of patients (patients of the same nosology, decreed contingents, persons from dispensary observation groups, etc.) begin to correlate with structures characteristic of the market. The field for the implementation of marketing relationships in medicine is certain segments of the medical services market, the diversity of which in form and content reflects in healthcare, as in the social structure of society, one of the principles of democracy. At the same time, with the equality of needs, generally referred to as medical, marketing relationships in health care give rise to fragmentation of the medical services market in accordance with certain, significantly different levels of needs for medical services. It is a wide range of medical needs, ranging from individual to group ones, their effective and high-quality satisfaction, taking into account diversity and commonality, that determine the essence of healthcare marketing systems. In this sense, the multistructural nature of health care systems, broad privatization, as an extreme form of decentralization, form the inalienable environment without which classical market relations are impossible.

The quality of medical care, free access to methods and forms of treatment, the natural possibility and implementation of the choice and appeal to any provider of medical services, the possibility of legal and economic influence in case of dissatisfaction or poor satisfaction of medical needs, earnings of a medical worker associated with the results of work and patient satisfaction, legal and economic security, both for the consumer and the provider of medical services - this is not a complete list of positive characteristics inherent in marketing healthcare systems. At the same time, it is necessary to reveal and explore the negative components of the medical services market. In particular, the negative nature of marketing relationships in health care includes the weakening of preventive measures, the rejection of medical services with a high share of the humanitarian mission of health care and a low degree of direct economic benefit, fears of discrimination against sick socially vulnerable groups in need of medical care, etc. remove with a methodological approach that considers such groups of patients, their medical needs and needs as peculiar and specific market segments, determines their rightful place in the healthcare marketing system and finds forms and methods to meet the needs and demand of customers of these segments.

Market segmentation is commonly referred to as the process of classifying consumers into groups with different wants and needs, characteristics, or behaviors. Such a definition, although acceptable for the medical services market, can hardly fully reflect the specifics and differentiation of the provision of medical care.

It is known that for the consumer goods market, customer groups can be formed according to the following criteria: geographical, demographic, psychographic, behavioral.
To be economically useful, a market segment must have the following five characteristics.

1. It must be possible to measure it, i.e. information on the fundamental parameters of the buyer can be obtained.

2. The segment must be broad and/or profitable enough to warrant a specific marketing plan.

3. Possibility of access. The enterprise must be able to effectively carry out its commercial efforts in the field of the selected segment.

4. Segments must be truly distinct, i.e. differ from one another in terms of set variables.

5. It must be possible for the enterprise to fulfill its plan.
Closely related to market segmentation is the essence marketing.

The strategy of undifferentiated marketing of medical services is to minimize differences between market segments, when first of all the general characteristics of consumers of medical services are taken into account, and then their difference. The medical and preventive institution seeks to obtain a license and introduce to the market such medical services (types of medical care) that will attract as many patients as possible and seeks to create a unique image in the mind of the buyer of medical services. Such a strategy is used if it can achieve cost reduction, but the company risks either getting into intense competition in this segment or incurring significant economic costs. Conditionally undifferentiated marketing of medical services could include immunoprophylaxis, preventive examinations of the population, etc. In all likelihood, within the framework of undifferentiated marketing of medical services, with its negative economic risks for the manufacturer, the points of application of state guarantees should be determined, i.e. in essence, the state should be the buyer of such medical services.

Differentiated marketing of medical services- development various kinds medical services and directed programs of medical actions for each segment; using variations of medical services and changing them, the medical institution (physician) hopes to receive higher revenue with optimal results and quality of medical care (CMC).

The dynamism of the health care strategy lies in the intelligent and timely combination of differentiated and undifferentiated marketing of medical services. The ability to transfer a consumer of medical services from one segment to another determines the dynamism and area of market viability of a medical institution or medical practice, and the relative degree of accessibility of medical services is characterized by the specificity of the market segment.

A medical service, being a specific form of a product, essentially determines the specificity of the segmentation of the medical services market.

Taking into account the relatively equal characteristics of consumers of medical services, market fragmentation can be carried out in two main directions:

social needs,

medical needs.

The fragmentation of the market according to the possibilities of demand for medical procedures is carried out in accordance with economic groups, which are characterized by the type of medical service, medical diagnostic group, cost of the procedure, solvency and personality of the patient.

The development of a possible classification of segmentation of the medical services market is presented according to the following parameters:

by age and sex characteristics (men, women, children, adolescents, adults, the elderly);

· by types of medical care (outpatient, hospital, obstetrics, dental, drug provision, etc.);

by decreed groups (healthy, sick, working in conditions associated with occupational hazards, military personnel, students, etc.)

· by nosological groups (as a special case - by clinical examination groups);

by medical diagnostic groups;

groups of equals medical standard;

by economic groups (well-being and solvency),

by types of medical services.

It is not possible to appeal to all health care buyers at once, as they have varied tastes and purchasing styles as well as income levels. From here, the direction of specialized segments of the medical services market emerges. In addition, competitors may well be located in some submarkets. Therefore, the health care institution (medical practices) should be interested in identifying those submarkets that will be most attractive to them and compatible with its goals and resources. With the same medical needs, needs, resources, geographical location, level of sanitary culture, purchasing attitudes, habits can be different. Any of these variables can be used as the basis for market segmentation. Ideally, a medical institution (the subject of medical practice) prefers to be the only one in its niche, the narrower this niche, the fewer competitors. But at the same time, the likelihood of large and wide sales of medical services also narrows.

The niche of the medical services market segment is the more attractive, the more it corresponds to the following characteristics:

A. Buyers of medical services (patients) have complex and specific needs in meeting medical needs;

B. they are willing to pay a high price in order to receive medical care of absolute quality, i.e. when medical procedures are absolutely adapted to their explicit and hidden needs;

B. the provider of medical services has a high, constantly improving professional and social competence;

D. the acquisition of this competence allows you to bypass competitors, hence “the ability of a medical worker to learn is becoming increasingly important quality, even more important than practical experience, which quickly becomes obsolete” (O.P. Shchepin).

There is no single method for segmenting the medical services market. It is necessary to test segmentation options based on different variables, one or more at once, to find the most useful approach to consider the structure of such a market. So the restructuring of the healthcare industry, taking into account its emerging marketing functions, in our opinion, should be carried out in accordance with the segments of the medical services market.

Apparently, state guarantees in the protection of the health of citizens should cover those market segments that are associated with the unattractiveness of the sector for the manufacturer of medical services, relying on profitability.

Thus, health care marketing systems, based on objective economic laws with many determinants, are characterized by certain market segments. Segmentation of the medical services market makes it possible to provide medical care (to satisfy a specific demand) both taking into account the individuality of the patient and taking into account the mass consumption of medical services.

5. general characteristics Russian market medical services.

The transition to market relations in Russia raised the question of pricing in all areas National economy one of the first places. Speaking about the price of a product in the health care system, we mean the price of a medical service that is fully endowed with commodity properties. Through the market mechanism, sellers and buyers interact to determine the price and quantity of goods produced. Therefore, demand, supply and price are the main elements economic relations on the market.

The key concept expressing the essence of market relations is competition. The pricing policy is formed in accordance with the structure of the market. Depending on the ratio between the number of producers and the number of consumers, the following types of competitive structures are distinguished:

Market perfect competition;

Oligopoly;

Monopoly;

Monopolistic competition.

The medical services market has the following characteristics:

The number of sellers is limited, there is a restriction on entering the market;

The heterogeneity of the medical service, its individuality, uniqueness;

Imperfect consumer awareness of the service market;

Impossibility or difficulty of comparing price and quality;

The presence of a large number of public or private non-profit organizations;

For the sale of goods in most cases, a competent intermediary is required, which pays for a significant part of the medical service.

Thus, the market of medical services for the most part can be attributed in structure to the market of monopolistic competition and monopoly.

Public health care is an example of a monopsony in the medical services market, when the level of prices at which medical services are purchased is determined not by the real costs of service providers, which no one considers, but by the solvency of the state and its ideas about the value of such a good as the health of citizens.

Thus, one can be convinced that the peculiarity of the Russian market of medical services is that it is a strong alloy of monopoly and monopsony, when almost all medical workers and medical institutions are under the jurisdiction of the Ministry of Health. At the same time, the state, being a monopolist, also dictates clearly unfavorable conditions for financing the structures subordinate to it, without even covering their real costs. The patient in such a system is alone and absolutely powerless. Therefore, the goal of the health care reform is to demonopolize the system of medical services, the gradual transformation of the Russian market of medical services first into a "seller's market", when sellers have greater market power (dictating their terms to the buyer, imposing goods (services) and prices for them), and then into "buyer's market", when the consumer-patient will become the central figure that determines the position of medical services and their price.

On the way to this, one of the priority tasks is to determine the legal and economic status of medical institutions and ensure their financing, based, at a minimum, on the real costs of producing medical services provided to the population. Funding at the level of real costs will ensure the financial sustainability of the country's medical institutions, allow them to move from solving problems of survival to problems of improving the quality of medical services.

When considering the market of medical services, it is necessary to pay attention to the factors that determine the demand and supply of medical services, the main of which is the price. The prices can be divided into the following three groups:

1st group - high prices (first price) for the service reflect its uniqueness, technological patent protection, lack of demand (demand market) at the initial stage;

2nd group - low prices(price of breakthrough or penetration) for the service, reflects the simplicity of the technical and technological solution, low costs, high and stable demand, durable financial position firms;

3rd group - experimental prices (when there is no such product on the market), reflect the novelty of the functional purpose, the lack of data on the emergence of a sales market and prices.

Also important is the interaction of the medical services market with the labor and labor market. material resources. On the one hand, the demand in the resource market is a derivative of the demand for medical services, on the other hand, the price level, and in general, the conjuncture in the resource market determines the potential opportunities and boundaries for the development of medical institutions.