Health Needs Assessment Flashcards
Health needs assessment definitions
A systematic approach for reviewing health issues affecting a population in order to enable agreed priorities and resource allocation to improve health and reduce inequalities
Factors involved in health needs assessment
Need - ability to benefit from an intervention
Demand - what people ask for
Supply - what is provided
Types of need
Felt need - individual perceptions of variation from normal health
Expressed need - individuals seeks help to overcome variation in normal health
Normative need - professional defines intervention for the expressed need
Comparative need - comparison between severity, range of interventions and cost
3 perspectives of a health needs assessment
Epidemiological perspective
Comparative perspective
Corporate perspective
Epidemiological perspective
Looks at:
1. Size of population - incidence/ prevalence
2. Services available - prevention/treatment/care
3. Evidence base - effectiveness/cost effectiveness
Sources: disease registry, admissions, GP databases
Good:
- Uses existing data
- Provices data on disease incidence/mortality/morbidity
Bad:
- Quality of data is variable
- Data collected may not be data required
- Does not consider felt needs/ options of patients
Comparative perspective
- Compares services/ outcomes received by a population with others
- Could compare different areas or patients of different aes etc
- Looks at: health status, service provision, outcomes
Good: - Quick and cheap if data available
- Shows if services are better or worse than compared group
Bad: - Can be difficult to find comparable population
- Data may not be available/ high quality
Corporate perspective
- Ask local populations what their health needs are
- Use focus groups, interviews, public meetings
- Wide variety of stakeholders
Good: - Based on felt and expressed needs of populations
- Recognises detailed knowledge and experience of those working with the population
Bad: - Can be difficult to distinguish needs from demands
- Groups may have vested interests
- May have political agendas
Resource Allocatin
Egalitarian = provide ALL care that is necessary and require for everyone
- Good: Equal
- Bad: Too expensive
Maximising = act is evaluated solely in terms of its consequences
- Good: resources allocated to those who are most likely to benefit from it
- Bad: Those who don’t make the cut receive nothing
Libertarian = Each is responsible for their own health
- Good: promotes positive engagement
- Bad: Most diseases are not self inflicted
Types of Prevention Important
- Primary prevention: Preventing the disease from occuring in the first place e.g. vaccine
- Secondary prevention: early identification of the disease to alter disease course e.g. screening
- Tertiary prevention: Limit consequences of established disease e.g. preventing worsening renal function in CKD
Approaches to prevention Important
- Population approach: prevention approach delivered to everyone to shift the risk factor distribution curve e.g. dietary salt restriction through legislation
- High risk approach: Identify individuals above a chosen cut off and treat them e.g. screening people for high blood pressure and treat them
- Prevention paradox: “A preventative measure which brings much benefit to the population often offers little impact to each participating individual”
Donabedians framework of health service evaluation
- Structure - what actually is the service e.g. how many heart surgeons there are
- Process – how does the process work
- Outcome – 5 Ds = death, disease, disability, discomfort, dissatisfaction
Issues with health outcomes: - Link between health service and health outcome can be difficult to
confirm - Time lag between service and outcome may be long
- Large sample sizes may be needed
- Data may not be available or have a problem with it (CART = completeness, accuracy, relevance, timeliness)
