Diagnosing and treating a population

Question 1

Define need

Answer 1

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

Question 2

What is bradshaws classification of need

Answer 2

Felt
Expressed
Normative
Comparative

Question 3

Describe normative needs

Answer 3

Professional define interventions apparopraite for expressed need

Question 4

Define comparative need

Answer 4

Managers and commisioners by comparisons between needs for severity size range of intervention and costs

Question 5

Give an example where need exists but is not demanded or supplied

Answer 5

Family planning and contraceptive services in LMICS

Question 6

Give an example where there is demand but no need or supply

Answer 6

Antibiotics for coughs and colds

Question 7

Give an example where there is a supply but no demand or need

Answer 7

Routine health checks for >75

Question 8

Give an example where there is a demand and a supply but no need

Answer 8

Request and be perscribed long acting benzodiazapines for insomnia

Question 9

What is a health needs assement

Answer 9

Process of identifying an unmet health and healthcare need and its ditribution, then making changes to meet that need

Question 10

Suggest four reasons why a needs assessment is done

Answer 10

Identifies inequities and inweualities
provides practical information for change
provides an opportunity for people to have a say
builds a cross-sectional partnership

Question 11

Who can a HNA be done on, how are they categorised?

Answer 11

By disease
use of healthcare service
type of intervention
indiviual or family ( housing food, sanitation)

Question 12

Define the 5 steps in a HNA

Answer 12

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

Question 13

What are three approaches to HNA

Answer 13

Epidemiological
comparative
corporate

Question 14

What data does an epidemiological approach use to define its pop and get an idea of the problem

Answer 14

Geopraphics
demographics
cenus 
death certificates
statistics
local surveys

Question 15

E approach- how is the size of the problem of disease in question assessed

Answer 15

risk factors
natural disease occurrence
incidence
prevalence

Question 16

How does a EHNA choose proirites to tackle the problem

Answer 16

RCTS

hierarchy of evidence

Question 17

How do Comparative HNA work

Answer 17

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

Question 18

How does a Corporate HNA work

Answer 18

build current model of are
compare observed and expected models, identify discrepancies inequities and inequalities
undertake systemic qualitative data from stakeholders and interest groups

Question 19

Who are stakeholders and interest groups

Answer 19

Patient communit groups
professional bodies
insurers
payers
clinicians
managers 
auiditors

Question 20

What is a Rapid Assessment procedure

Answer 20

Used in emergancies
work on limited information and using little resources
rapid planning and implementation

Question 21

What data sources are there in a RAP

Answer 21

wuick surverys interviews focus groups discussions community mapping and observation

Question 22

Suggest 6 data challenges in HNA

Answer 22

Availability/extent
validity/reliabilty
non-existant
contradictory answers
not robust
missing or incomplete
data protection lawsprivate secotr reluctance

Question 23

What are the benefits of involving the commuity in a HNA

Answer 23

improves understanding and making informed choices
collective identification of needs
empowerment and ownership
better acceptance and therefore implementation

Question 24

What three ethical theories are there

Answer 24

Virtue ethics-actor/agent
Ethical duties- Action deontolgy
Utilitarism- results or consequentialism