Diagnosing and treating a population Flashcards
Define need
the capacity to benefit
capacity being the abillity to make use of a needed intervention and benefit being the reducaiton in disease or disability/improvement of health
What is bradshaws classification of need
Felt
Expressed
Normative
Comparative
Describe normative needs
Professional define interventions apparopraite for expressed need
Define comparative need
Managers and commisioners by comparisons between needs for severity size range of intervention and costs
Give an example where need exists but is not demanded or supplied
Family planning and contraceptive services in LMICS
Give an example where there is demand but no need or supply
Antibiotics for coughs and colds
Give an example where there is a supply but no demand or need
Routine health checks for >75
Give an example where there is a demand and a supply but no need
Request and be perscribed long acting benzodiazapines for insomnia
What is a health needs assement
Process of identifying an unmet health and healthcare need and its ditribution, then making changes to meet that need
Suggest four reasons why a needs assessment is done
Identifies inequities and inweualities
provides practical information for change
provides an opportunity for people to have a say
builds a cross-sectional partnership
Who can a HNA be done on, how are they categorised?
By disease
use of healthcare service
type of intervention
indiviual or family ( housing food, sanitation)
Define the 5 steps in a HNA
1) Define the pop and objective
2) identify health priorites/interventions
3) choose priorites for change
4) action plan -who what where how costs
5) implementation monitoring and evaluation of the change
What are three approaches to HNA
Epidemiological
comparative
corporate
What data does an epidemiological approach use to define its pop and get an idea of the problem
Geopraphics demographics cenus death certificates statistics local surveys
E approach- how is the size of the problem of disease in question assessed
risk factors
natural disease occurrence
incidence
prevalence
How does a EHNA choose proirites to tackle the problem
RCTS
hierarchy of evidence
How do Comparative HNA work
comes up with models of care for the probelm in question and compares interventions and succes for similar pops, setting and services across other countries/services or providers
How does a Corporate HNA work
build current model of are
compare observed and expected models, identify discrepancies inequities and inequalities
undertake systemic qualitative data from stakeholders and interest groups
Who are stakeholders and interest groups
Patient communit groups professional bodies insurers payers clinicians managers auiditors
What is a Rapid Assessment procedure
Used in emergancies
work on limited information and using little resources
rapid planning and implementation
What data sources are there in a RAP
wuick surverys interviews focus groups discussions community mapping and observation
Suggest 6 data challenges in HNA
Availability/extent validity/reliabilty non-existant contradictory answers not robust missing or incomplete data protection lawsprivate secotr reluctance
What are the benefits of involving the commuity in a HNA
improves understanding and making informed choices
collective identification of needs
empowerment and ownership
better acceptance and therefore implementation
What three ethical theories are there
Virtue ethics-actor/agent
Ethical duties- Action deontolgy
Utilitarism- results or consequentialism
