Health Needs Assessment Flashcards
What are the stages of the needs assessment and planning cycle?
- Needs Assessment
- Planning
- Implementation
- Evaluation
What is the DofH and NICE definition of need?
The ability to benefit from an intervention
What are demand and supply?
Demand - what people ask for
Supply - What is provided
What is the NICE definition of 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 health and reduce inequalities
What is the difference between health need and health care need?
Health need is more general and is measured using morbidity, mortality and socio-demographic measures
Health care need is more specific and is the ability to benefit from healthcare. It depends on the potential of prevention, treatment and care SERVICES to remedy health problems
In reality, health needs assessment covers both these terms
Who/what might a health needs assessment be carried out for?
A population or subgroup - eg Manor practice population
A condition - eg COPD
An intervention - eg coronary angioplasty
Who defines need?
Individuals family community professionals Society
Give an example of a condition/intervention that is defined by individual need?
Back pain and to an extent IVF
Give an example of a condition/intervention that is defined by family need?
Care for children with learning disabilities
Give an example of a condition/intervention that is defined by community need?
Circumcision - religious groups in society
Give an example of a condition/intervention that is defined by professionals?
New cancer treatment - can also be defined by Big Pharma as well as researchers
Vaccination
Give an example of a condition/intervention that is defined by society?
IVF - to an extent the acceptability of this ethically is defined by society, though individual areas may decide how many cycles
Abortion
What are the types of need in the sociological perspective of need
Felt need
Expressed need
Normative need
Comparative need
Who developed the sociological perspective of need?
Jonathan Bradshaw
What is felt need?
Individual perceptions of variation from normal health
What is expressed need?
Individual seeks help to overcome variation in normal health
What is normative need?
professional defines intervention appropriate for the expressed need
What is comparative need?
Comparison between severity, range of interventions and cost (lecture)
From Bradshaw’s book - compared to an area where the population are in receipt of a service, a similar population that is not in receipt of a service is therefore in need
What are the different approaches taken in a health needs assessment?
- Epidemiological
- Comparative
- Corporate
What is the epidemiological approach to the health needs assessment?
- Define a problem
- Size of the problem - incidence/prevalence
- Services (that could be) available (but aren’t)- prevention/treatment/care
- Evidence base - effectiveness and cost-effectiveness
- Models of care - quality and outcome measures
- Existing services - unmet need; services not needed
- Recommendations eg NICE guidelines, Department of Health
List some problems with the epidemiological approach
- required data may not be available
- available data may not be of good quality
- Does not consider the felt needs of individuals affected
What is the comparative approach to the health needs assessment?
Compares the services received by a population/group to others
Compares:
1. location of the populations
2. social characteristics of populations eg age, gender, class, ethnicity
3. health status (what conditions they have, symptoms, comorbidity)
4. service provision (what services are provided)
5. service utilisation (what services are being used)
6. Health outcomes of the two populations (mortality, morbidity, quality of life, patient satisfaction)
List some problems with the comparative approach
- data about the popualtions (eg service provision, utilisation and health outcomes) may not be available
- data may be of variable quality
- may be difficult to find a comparable population
- May not help to identify what the most appropriate level of provision or utilisation should be
Describe the corporate approach to the health needs assessment
This is where the views of different groups of people are taken into account to assess the need of a population or group
Who’s views may be considered in a corporate approach?
Professionals Patients Press Politicians Commissioners Providers
List some problems with the corporate approach
- Difficult to distinguish need from demand
- Groups may have vested interests (press, Big Pharma)
- May be influenced by political agendas
- Dominant personalities may have undue influences (eg louder voices)
Give some examples of situations where a health needs assessment may be done
To assess the health needs of patients with stroke in Sheffield
To assess the need for sexual health services
(so can assess the health needs of people or their health care needs)
Something that is demanded but not needed or supplied and explain your reasoning
Cosmetic surgery - not supplied as not funding available within the NHS and is often not considered medically beneficial
Sick notes in some circumstances
Something that is needed, but not demanded or supplied and explain your reasoning
Dieticians for IBS - often needed as the FODMAP diet is difficult to understand/follow, but is often not offered by general practitioners and hence patients may not be aware about this service to ask for them (especially as I think they need to be referred to a gastroenterologist to be able to access this - double check with a GP)
Something that is demanded and needed, but not supplied and explain your reasoning
Adequate provision of mental health services
GP appointments
Organ transplant
Something that is demanded and supplied, but not needed and explain your reasoning
Unnecessary antibiotics for colds
Something that is needed and supplied, but not demanded and explain your reasoning
Childhood vaccinations
Statins
Something that is needed, demanded and supplied and explain your reasoning
Contraception
