Health Needs Assessment (Epidemiology)

Question 1

Health needs are comprised of:

Answer 1

Basic health needs - food, water and shelter

Community health needs - prevention of disease and promotion of health e.g. vaccines

Patient healthcare needs - effective treatment and care

Question 2

Bradshaws taxonomy of need

Answer 2

Felt need - need expressed by patient

Expressed need - demand placed upon healthcare service

Normative need - endorsed by a health professional

Comparative need - defined at population level

Question 3

Define Health Needs Assessment

Answer 3

Based on patient healthcare needs

A systematic method for reviewing health needs of the population to prioritise resource allocation, which will improve health and reduce inequalities

Question 4

Role of NICE

Answer 4

Role in assessing health need, treatment effectiveness, and cost effectiveness

Question 5

Elements to health needs assessment

Answer 5

1. Epidemiological- Which treatment Is effective and in which subgroups? How many people will benefit?
2. Comparative - between populations, can indicate unmet needs (e.g. if population A has higher need for hip replacements than B, it could indicate that people in population B are going without despite needing them)
   Other reasons for variation:
   Difference in disease prevalence
   Data quality and reliability
   Population structure
   Case ascertainment, diagnostic and treatment criteria
   Treatment supply
   Healthcare priorities
3. Corporate needs - consultation process to assess local priorities and expert opinions, politicians, stakeholders, patients. Not evidence based.

Question 6

Challenges of health care assessment

Answer 6

• Difficult to measure benefit for chronic illness
• “Needs” change as treatment advances
• Difficult to define who will and won’t benefit from an intervention

Question 7

Define Need, Demand and Supply

Answer 7

Need - what healthcare patients would benefit from

Demand - what treatment patients would like to use (or are prepared to pay for - including being taxed for)

Supply - what is actually available

Question 8

Reasons for imbalances in need-demand-supply

Answer 8

Increasing needs and demands
- ageing population
- new treatments leading to new standards of care
- rising expectations

Limitations of supply
- Staffing issues
- public spending restraints
- limited taxation

Question 9

Consequences of unmet need

Answer 9

• Suffering, disability and death
• Waiting patients presenting as emergency cases
• Worsening conditions requiring more complex procedures
• Rationing of services - waiting lists
• Low patient satisfaction
• Professional dilemmas, moral injury
• Political pressure

Question 10

Rationing me