Health needs assessment in practice.

Abstract

1. Development and importance of health needs assessment 2. Needs assessment: from theory to practice 3. Epidemiological issues in health needs assessment 4. Whose priorities? Listening to users and the public 5. Assessment in primary care: practical issues and possible approaches 6. Health needs assessment is not required for priority setting 7. Health Care Needs Assessment: The Epidemiologically Based Needs Assessment 8. Learning needs assessment: assessing the need 9. Interventions must be effective to be needed 10. Needs assessment, priority setting, and contracts for health care: an economic view 1) Development and importance of health needs assessment BMJ1998;316:1310-1313(25 April) This is the first in a series of six articles describing approaches to and topics for health needs assessment, and how the results can be used effectively John Wright, consultant in epidemiology and public health medicine, a Rhys Williams, professor of epidemiology and public health, b John R Wilkinson, deputy director of public health. c Most doctors are used to assessing the health needs of their individual patients. Through professional training and clinical experience we have developed a systematic approach to this assessment and we use it before we start a treatment that we believe to be effective. Such a systematic approach has often been missing when it comes to assessing the health needs of a local or practice population. The health needs of individual patients coming through the consulting room door may not reflect the wider health needs of the community. If people have a health problem that they believe cannot be helped by the health service, then they will not attend. For example, many people with angina or multiple sclerosis are not known to either their local general practitioner or to a hospital specialist. 1 2 Other groups of patients who may need health care but do not demand it include homeless people and people with chronic mental illness. Distinguishing between individual needs and the wider needs of the community is important in the planning and provision of local health services. If these needs are ignored then there is a danger of a top-down approach to providing health services, which relies too heavily on what a few people perceive to be the needs of the population rather than what they actually are. Summary points  Health needs assessment is the systematic approach to ensuring that the health service uses its resources to improve the health of the population in the most efficient way  It involves epidemiological, qualitative, and comparative methods to describe health problems of a population; identify inequalities in lth and access to services; and determine priorities for the most effective use of resources  Health needs are those that can benefit from health care or from wider social and environmental changes  Successful health needs assessments require a practical understanding of what is involved, the time and resources necessary to undertake assessments, and sufficient integration of the results into planning and commissioning of local services.