Analytical Models for Decision Making

In this chapter you will learn about strategic intervention to ensure that health services are efficient and equitable. Among the tasks involved are estimating and forecasting the health care needs of populations, and ensuring that the existing configuration of services can meet these needs. A brief discussion of corporate needs assessment, in which an attempt is made to balance or resolve the various interest groups and pressures bearing on the service, is followed by a review of needs assessment based on a combination of data on the population served, evidence about the effectiveness and acceptability of treatment and explicit judgements about priorities, and the potential contribution to this of mathematical modelling.

By the end of this chapter, you will be better able to:

•	explain the concept of need for health care and the implications for strategic intervention in publicly funded health care systems
•	explain the role of needs assessment in strategic intervention
•	describe the strengths and weaknesses of corporate needs assessment
•	describe the strengths and weaknesses of a variety of approaches to population-based needs assessment, ranging from a crude norms-based approach to a full evidence-based approach

Corporate needs assessment A more or less formal process for adjusting the provision of health
services in response to pressures for change from providers, central policy makers, professional
bodies, patients and representatives of the public.

Evidence-based needs assessment A process through which the provision of health care can be
responsive to the characteristics of the population served and evidence about the effectiveness
and acceptability of the services in question.

Population-based needs assessment A process through which the provision of health care can
be responsive to the characteristics of the population served.

Population need for health The gaps between actual and desired levels of health in a
population.

-121-