The influence of health needs assessment on health care decision-making in London health authorities.
Health needs assessment gained prominence under the model of health care purchasing developed to support the 1991 reforms of the UK National Health Service (NHS).
The objectives of this paper are to determine how needs assessment has been used in the NHS, to assess the influence it has had on decision-making, and to relate the observed uses of needs assessment to competing theoretical models of health care policy-making.
A survey of needs assessment activity in 14 London health authorities identified 217 needs assessments conducted between 1993 and 1996.
Semi-structured interviews were conducted with public health and commissioning staff in each authority.
The survey indicated that needs assessment directly supported decision-making and action in two-thirds of the studies identified, but up to 20% of needs assessments had no impact on service provision.
Four key functions of health needs assessment were observed :
identifying a problem ;
planning detailed changes to services ;
providing post hoc justification for earlier decisions ;
and using participation in needs assessment to build « ownership » of subsequent decisions.
The survey suggests that needs assessment is, in practice, consistent with a « mixed scanning » model of decision-making.
Needs assessment is used to help select issues for detailed investigation and to direct analytical and decision-making resources. (...)
Mots-clés Pascal : Information, Santé, Evaluation, Royaume Uni, Contrôle, Entretien, Processus, Méthodologie, Besoin, Grande Bretagne, Aide décision, Politique sanitaire, Offre, Soin
Mots-clés Pascal anglais : Information, Health, Evaluation, United Kingdom, Check, Interview, Process, Methodology, Need, Great Britain, Decision aid, Health policy, Offer, Care
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 06/10/1999.