Health Needs Assessment

Question 1

Health needs assessment definitions

Answer 1

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

Question 2

Factors involved in health needs assessment

Answer 2

Need - ability to benefit from an intervention
Demand - what people ask for
Supply - what is provided

Question 3

Types of need

Answer 3

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

Question 4

3 perspectives of a health needs assessment

Answer 4

Epidemiological perspective
Comparative perspective
Corporate perspective

Question 5

Epidemiological perspective

Answer 5

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
- Provides 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

Question 6

Comparative perspective

Answer 6

• Compares services/ outcomes received by a population with others
• Could compare different areas or patients of different ages 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

Question 7

Corporate perspective

Answer 7

• 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

Question 8

Resource Allocation

Answer 8

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

Question 9

Types of Prevention Important

Answer 9

• 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

Question 10

Approaches to prevention Important

Answer 10

• 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”

Question 11

HNA Framework

Answer 11

1. Identify health problems
2. Assess demand for services
3. Evaluate available resources
4. Prioritise intervention