Health needs assessment Flashcards
What is a normative need?
A need which is identified according to a norm (or set standard); such norms are generally set by experts e.g. means-tested benefits
What is a comparative need?
Concerns problems which emerge by comparison with others who are not in need e.g. comparison of social problems in different areas in order to determine which areas are most deprived
What is a felt need?
A need which people feel - that is, need from the perspective of the people who have it
What is an expressed need?
The need a person says they have. People can feel need which they do not express and they can express needs they do not feel (= demand)
What is the rationale behind describing a need as the capicity to benefit?
The rationale for this is that there is limited value in identifying a need if there is nothing that the health care system can do about it.
Give an example of a service that is needed but is often not supplied or demanded.
Family planning and contraceptive services are needed in many low and middle income countries to improve women’s reproductive health
They are frequently neither demanded or supplied
Give an example of a service where there is a demand but no need or supply.
Patients may ask for (demand) expectorants for coughs and colds
However, cough mixtures are ineffective and should be seldom prescribed (no need or supply)
Give an example of supply but no need or demand.
The provision of routine health checks in people over 75 years are not usually requested (no demand), but in some general practices they are provided (supply)
Research suggests that the benefits of such checks do not outweigh the costs (no need)
Given an example of demand and supply but no need.
People may request (demand) and be prescribed (supply) long-acting benzodiazepines (sleeping tablets) for insomnia
In the long term this is not effective (no need)
Give an example of need and demand but no supply.
Substance misuse is common and is associated with morbidity (ill health) and mortality (death)
Methadone maintenance programmes can reduce the physical risks of heroin addiction and may increase the chance of drug misusers giving up (need), but it is not always available (no supply)
Give an example of need and supply but no demand.
Even when it is offered, not all health-care staff take up the opportunity of hepatitis B immunisation (supply but no demand)
Yet they are at risk of hepatitis B infection and immunisation is effective at preventing it (need).
Give an example of need, demand and supply.
People with insulin-dependent diabetes ask for (demand) insulin, it is effective at maintaining their health (need) and the NHS can afford to provide it (supply)
What is a health needs assessment?
- A systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve and reduce inequalities
- Also includes assessment of effectiveness and priority setting
- If latter not included is really a health status assessment, not assessment of needs per se
- If focus on equity specifically, called an equity profile/ audit
Why do a health needs assessment?
- It is the first step to improve the population’s health
- It helps to prioritise resources
- It helps to make an evidence based case for resource allocation enabling accountability
- It is a wider starting point of need than just service provision (supply)
- The process allows reflection for what should happen
- Can identify causes of health inequality
- It raises understanding of local health problems
What are the different types of health needs assessment?
•Epidemiological
–Measure health status of population
–Evaluate means of addressing identified health problems
–Can be difficult/expensive
•Comparative
–Compare with service provision in similar populations
–What if they have got it wrong?
•Corporate
–Ask experts
–Usually local experts with vested interest!
