Health Needs Assessment Flashcards
What is the Health Needs assessment?
When we want to improve the health of a population or population subgroup, we ideally start with a heath needs assessment, followed by the other phases of the planning cycle.
Whats the planning cycle of the Health Needs assessment?
Needs assessment > Planning > Implementation > Evaluation > Planning
As doctors, what 2 main ways will we improve the health of our patients?
Treating individual patients
Influencing the services available to patients
What kind of service are offered at a GP?
MH practioners
Social prescribers
ANPs
Clinical pharmacist
Healthcare assistant
Physiotherapist
What is the sociological perception of need (Bradshaw 1972)
Felt: Individuals perceptions of variation from normal health
Expressed: Individuals seeks help to overcome variation in normal health
Normative: Professional defines intervention appropriate for the expressed need
Comparative: comparison between severity, range of interventions and cost
What is the capacity to benefit?
Individual’s capacity to benefit from an intervention - importance of effectiveness of health interventions
Make explicit what benefits are being pursued (Wright et al, 1998)
There can be no rational need for an individual or a population to receive care that has no benefit (Stevens & Gabbay, 1991
What is the taxonomy of need?
Wants (Felt needs) > Demands (expressed needs) > Needs (normative needs) > met + unmet
From the met needs we take SUPPLY
How do we identify unmet needs?
requires a public health focus.
Can be expressed as the relationship between :
Needs (unidentified, unmet, and met)
Services(appropriate and inappropriate)
What is the inverse care law?
‘the availability of good medical care tends to vary inversely with the need for it in the population served.’ Tudor Hart Lancet 1971; i: 405-412
What is Need, supply and demand?
Need is the ability to benefit from an intervention
Supply is what we actually provide
Demand / want is what people ask for
What are the 3 main approaches to Health Needs Assessment?
Epidemiological
Corporate
Comparative
What is considered in the epidemiological approach to a Health Needs assessment?
Person - Who are the affected people - age, gender, occupation, SEGP
Place - Where + When they get diseases, and do prevalence and incidence vary geographically?
Time - When do people get diseases? - Vary by season or cycles
What is the outline of the epidemiological approach?
Statement of the problem - case definition
Prevalence and incidence
Services available and their costs
Effectiveness and cost-effectiveness of services
Quantified models of care and recommendations
Information and research requirements
What is the disadvantage of the epidemiological approach?
Re-enforces a biomedical model.
Reliant on the quality and availability of data
Requires suitably trained staff to analyse data
What are the different sources of Data?
Routine information sources
Survey Data
What is involved in Routine Information Sources?
Population and census data
- Including measures of deprivation
Mortality data
- National registration of deaths
- Perinatal/infant mortality “rates”
Morbidity data
- Local/national registries
- Primary care data
- Prescribing data
- Health Care
- Hospital activity data
What is show in Survey data?
Survey Data
Cross sectional or longitudinal
Clear aim
Case definition and population at risk
Staff and resources needed
Sample size
Precision v resources
Representativeness
Valid, reliable instrument
What is the corporate approach to Health Needs Assessment?
Structured collection of knowledge and views of stakeholders – focus group, interviews used.
Based on the demands, wishes and perspectives of interested parties - professional, political and user/public views
Recognition of importance of knowledge available from those who have been involved in local service
What are the disadvantages of the Corporate approach to Health Needs Assessment?
Blurs difference between need and demand, and between science and vested interest
if used in isolation it may reflect demand and supply rather than ‘need’
stakeholders concerns may be influenced by political agendas
What are the factors that are taken into account for the corporate approach to Health Needs Assessment?
Doctors
Nurses
PH Doctors
Commissioning manager
Voluntary organisations
Community health councils
Trust managers
Patients
GPs
What is the comparative approach to a Health Needs Assessment?
Compares health performance across or between communities, disease groups, service providers.
Measure variation in cost and service use
Fairly quick and inexpensive to achieve
What are the disadvantages of the comparative approach to Health Needs Assessment?
Hard to find similar comparator
Often knowledge of optimum service not known (try to base on national recommendations)
Usage rates may vary markedly, for unexplained reasons
Link between usage rates and health outcomes may be hard to demonstrate
Who should do the HNA?
Public Health Staff?
Health visitors?
Voluntary organisation staff?
Community workers?
What are the benefits of HNA?
Strengthening community involvement in decision making
Improved public participation
Improved team & partnership working
Professional development of skills
Improved patient care
Improved communication with other agencies and public
Better use of resources
