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The physician needs assessment allows a health care organization to figure the number and mix of physicians it will need, assisting in targeted, realistic recruitment efforts. It forms a key piece of your organization's strategic plan, lays out the current specialty mix, helps justify recruitment plans to your medical staff and the physicians you are recruiting, and can maintain your practice's good standing with regulatory agencies.
Meeting the needs of HIV-infected patients in a focused, cost-efficient, coordinated manner is one of the most challenging problems in health care today. Before developing an intervention program, accurate surveys of need must be done. This article presents one such needs assessment conducted in a rural section of the Midwest. The assessment consisted of (1) surveys of HIV+ individuals/people with AIDS, area physicians, and local key informants and service providers, and (2) statistical data from health departments. Results of analyses suggest that access to primary care, self-care education, mental health and family support services, case management, financial assistance, community education, and home health services are this community's highest priority needs.
A national needs assessment survey is described that gathered information on current practices in physical education in both center-based schools for the deaf and mainstream programs serving deaf and hard of hearing students, grades K-12. The manner in which deaf and hard of hearing students are being served in physical education programs, the depth and breadth of curricula, and the credentials needed to teach are described. The study compares similarities and differences among physical education programs in center-based deaf institutions and mainstream schools. In summary, the study identifies areas of concentration needed in curriculum, and methods of teaching appropriate for student teacher candidates. This information has value for physical education programs that are considering revising their curricula to prepare teacher candidates who wish to work with deaf students.
Needs assessments are essential to educational program development. Methods of needs assessment include environmental scans, surveys, and focus groups. Focus groups are valuable and acceptable tools to identify learner needs. The method is a qualitative research technique that is most useful to identify the range of opinions or ideas on a topic. The purposes of this paper are to explore the literature in focus groups for continuing education research, to provide information on the reasons and methods to conduct focus groups, and to present findings of participants' views of the focus group process.
It is increasingly recognised that population health need assessments based on the comparison of clinical or demographic end points (e.g. area mortality rates) neglect population variation in broader aspects of health status and health-related quality of life. Similarly, outcome measures which neglect impacts on health-related quality of life may be an inadequate basis for assessing the effectiveness of health interventions. This paper reviews issues in assessing needs and outcomes at population level based on health status valuations. It considers especially the modelling of sources of uncertainty in measures of health status by using Bayesian sampling estimation methods which produce a distribution of summary outcome measures. The modelling issues are illustrated in models for individual level health status from survey responses and their incorporation in area life tables to derive total and healthy life expectancies. In particular, a health status index derived from Short Form 36 profile responses in a health and lifestyle survey in a London health authority provides a case study of community health needs assessment.
As a step toward developing criteria for referral to occupational therapy, the study set out to assess patients' needs of occupational therapy in an acute cancer care hospital. A 31-item Needs Assessment Questionnaire was produced. It was intended to reflect interventions/ measures of occupational therapy. Seventeen questions eliciting information on occupational therapy gave a factor with an alpha coefficient of 0.92. Four single questions on occupational therapy did not form a factor. Six questions about the disease had an alpha coefficient of 0.83, whereas four about rehabilitation prognoses formed a factor with an alpha coefficient of 0.57. The questionnaire was completed by 40 day-shift primary-care nurses acting as key informants. Their answers concerned a total of 88 of their patients. Twenty-six percent of the patients had been recommended for or referred to occupational therapy, whereas many whom the nurses judged to need this (47%) had not been referred (p = 0.01 chi-squared test, 10.59 McNemar test). Hence, no logical pattern of referral was found, and this seems to highlight both the absence of and the need for clear referral criteria.
BACKGROUND: Staff and severely mentally ill patients differ in their assessments of need. This study compares staff and patient assessments of need for people suffering from psychotic disorders. METHOD: The needs of an epidemiologically representative sample of 137 patients from a catchment area psychiatric service in South London who had an ICD-10 diagnosis of a functional psychotic disorder were assessed cross-sectionally by patients and staff, using the Camberwell Assessment of Need. RESULTS: Staff rated patients to have on average 6.1 needs, and patients rated 6.7 needs (t = 2.58, df = 136, P = 0.011). This difference was accounted for by the staff rating of 1.2 unmet needs and the patient rating of 1.8 unmet needs (t = 3.58, df = 136, P < 0.001). There was no difference in rating of total number of met needs. There was no difference in ratings in relation to any patient sociodemographic characteristics. There was moderate or better agreement on the presence of a need for 13 of the 22 domains in the Camberwell Assessment of Need. CONCLUSIONS: Staff and patients moderately agree about met needs, but agree less often on unmet needs.
Health authorities and health boards in the UK are required under the provisions of the NHS Act, 1990, to assess the needs of their resident populations for health care and, through contracting, to act as purchasers of services informed by those needs. This paper presents an economic approach to informing the purchaser on priority setting for contracting. For illustrative purposes, the technique is applied to services for elderly people with dementia. The paper demonstrates that an economic approach to needs assessment is both desirable and practicable.
Assessments of need carried out so far have concentrated on single diseases or interventions rather than care groups or on people who have multiple pathologies. We therefore began a needs assessment for older people in a central London health authority. The health district--then called Parkside--covered 25 square miles in north London and had a resident population of 432,600 people, of which 7% were aged 75 years and over and 2% were aged 85 years and over. Estimates of the number of people with different disabilities and diseases were calculated using data from the General Household Survey, the office of Population Census Survey (OPCS) Disability Survey or other national or reliable surveys. Although the majority of older people were well--indicating a need for health promotion and disease prevention--we estimated the number of disabled older people in the district was in excess of 25,000, with the most common types of disability being those concerned with locomotion, hearing and personal care. Using data from the OPCS survey we were able to estimate there were 7328 people aged 75 years and over who were in the OPCS top five severity rating, which would mean that they probably required services. For mental health we estimated there would be approximately 6000 older people suffering from clinically significant depression, 6000 older people suffering from anxiety, and between 2740 and 4441 suffering moderate to severe dementia. A next step is to match an assessment of the prevalence of disease and disability, with an estimate of that being served locally.
BACKGROUND: Since 1999, prison health services and health authorities have been jointly responsible for assessing the health care needs of the prison population. To facilitate this process, the Department of Public Health and Epidemiology at the University of Birmingham developed a toolkit for carrying out a health care needs assessment of the prison population. METHODS: This paper describes the principles of the epidemiological approach to needs assessment and presents a stepped approach to carrying out a health care needs assessment in prisons. Some examples of the kind of health care needs to be found in prisons are presented. RESULTS: A systematic approach to the assessment of the health care needs of prisoners ensures that all the essential components of this important planning exercise are considered. The prison population is described, health problems are identified and quantified, and a review of current services is carried out. This allows the most effective solutions to addressing the health problems to be established. The process can be time consuming and is reliant on good data sources, but it does ensure that health problems and service elements are considered and addressed together rather than in a disjointed manner. CONCLUSION: The stepped approach to epidemiological needs assessment allows health problems and current services to be identified. It also allows these to be matched to appropriate service requirements.
Needs assessment remains an inexact yet evolving field of activity in palliative care. One reason for the variable quality of needs assessments in palliative care is the pragmatic orientation that comes from limited time and resources. Consequently a comprehensive approach to palliative care needs assessment is often not achieved. One route to its improvement lies in sharing experiences about techniques and methods in conducting needs assessment studies. In this paper we offer some thoughts on our own experience of conducting needs assessment for palliative care in three separate locations within a single English health region. We describe the context in which the projects were conducted; the background and origin of each study; the aims and methods used; the research process in each case; key findings; as well as the dissemination process and impact of the work. We show some of the different forms which palliative care needs assessment can take and conclude with some general principles intended to improve practice in this challenging area of health services research.
OBJECTIVES: To do a needs assessment directed to neurologists attending a workshop on communication skills emphasizing relationships between physician and patient, assessment of disability and quality of life of migraine patients, and communication of therapies for migraine. METHODS: A structured questionnaire was sent to all participants related to the issues indicated in the objective. This was prepared by the faculty and the results were collated by the author and presented at the beginning of the workshop. This paper overviews the use and results of a needs assessment to highlight learning needs of the participants and to focus the issues, interest and interactions of neurologists in a workshop. The workshop focused primarily on communication skills and on the understanding of disability and quality of life issues in migraine patients. RESULTS: In general the responses revealed that the attendees were neurologists in practice for more than 15 years, that over 50% had prior knowledge of communication skills and used them in various ways, and 74% were involved in teaching family physicians. Some knew and used disability and quality of life tools but up to one third of participants did not assess disability in their patients. Most wanted to learn more about communication skills and other objectives noted and 19% of respondents wanted to learn more about prophylactic antimigraine treatments and how to differentiate/contrast the triptans. CONCLUSION: Using a needs assessment tool allowed organizers of an educational workshop to determine the current knowledge and perceived and unperceived needs of the participants with respect to communication skills, assessing disability and quality of life issues, and communication of treatments to migraine patients.
Community health needs assessment has traditionally been an integral part of the health visitor's public health activities. The NHS reforms, and in particular GP fundholding, threaten this aspect of their role. Stephen Peckham and Jacqui Spanton argue that, far from restricting the health visitor's work in this area, purchasers and providers should be investing in community-based information collection, in order to obtain the data vital to provision of locality-sensitive services, and that health visitors should re-discover their role as public health advocates.
Needs assessment has become an integral step in planning for continuing education. This article describes a computer-based needs assessment system that has been used successfully in planning continuing dental education in South Carolina. The Statewide Needs Assessment Program (SNAP) provides a general purpose system for collecting and analyzing continuing education needs data for large populations. Needs assessment data from 489 practicing dentists in South Carolina are presented and analyzed.
This is a synthesis of the presentations and discussions pertaining to Needs Assessments of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO), in Phuket, Thailand, 04-06 May 2005. The topics discussed included: (1) Needs assessments; (2) Coordination; (3) Effectiveness of needs assessments; (4) Needs assessments change; (5) Qualifications for conducting needs assessments; (6) Dissemination; (7) Emergencies overlay background needs assessments; (8) Need for standards; and (9) Conclusions and recommendations.
OBJECTIVE: To determine the ability of dental nurses in Anguilla to assess treatment need following training in WHO criteria. PARTICIPANTS: Sixty-six randomly selected schoolchildren aged 6, 9, 12, 14, 15 and 17 years. DESIGN: Point prevalence study involving three different groups of schoolchildren [n = 20 (C0), 23 (D1), 23 (D2)] and four plaster casts comprising 52 extracted teeth (T0). MAIN OUTCOME MEASURES: Tooth- and person-based inter and intra-examiner agreement. METHOD: The only three government dental nurses in Anguilla were trained and calibrated by a benchmark dentist in June 2000 using WHO criteria. Tooth-based Treatment Need and person-based Treatment Urgency were assessed during 466 evaluations involving 1,733 teeth. Examiner agreement levels were compared during two calibration exercises (T0, C0) and two duplicate examinations (D1 and D2). The treatment components were classified as preventive (diet modification, prophylaxis, OHI, sealants); restorative (restorations, pulp care and crowns); and rehabilitative (tooth removal). RESULTS: All scores presented are Kappa scores. Substantial agreement was obtained at T0 (0.614-0.764), and almost perfect agreement at C0(0.832-0.872), D1(0.917-0.954) and D2(0.966-0.977). Almost perfect reliability occurred at C0(0.963-0.991) and D1(0.971-0.992) while perfect reliability was attained by all examiners at D2(1.0). Substantial and almost perfect agreement was obtained for all treatment modalities irrespective of caries prevalence and severity. Agreement levels increased as the survey progressed. Perfect agreement was obtained for all categories of treatment urgency. CONCLUSIONS: Dental nurses in Anguilla can validly and reliably assess treatment need provided training is adequate, of realistic duration and they are involved in all aspects of the exercise.
An assessment of health promotion needs represents a fundamental step for developing comprehensive school health programs. This project developed and tested an approach for school districts to use when conducting a district-wide needs assessment of school health programs. The approach assumes a needs assessment should be multidimensional and comprehensive. Seven priority health-related behaviors were included as well as eight components of a school health program identified by Kolbe. This paper describes each aspect of the needs assessment, discusses the importance of perspectives provided by each component, and provides recommendations for districts interested in conducting an assessment.
The purpose was to examine the concurrent criterion-based validity of different measures used in a statewide in-home need assessment survey of a representative sample of 570 older persons. Need was measured and defined in four different ways in six problem areas. The criterion measure was a life satisfaction scale. The set of four need measures yielded a significant multiple R, indicating that the set would generally be related to life satisfaction in older persons. Individually, three of the four need measures made significant contributions. The set of six problem areas also yielded a significant multiple R, with four (Mental Health, Health, Income, Nutrition) making significant individual contributions. Implications for need assessment measurement included: that problem-focused measures are strongly and generally related to need satisfaction, whereas service-focused measures have problems; that both evaluative and descriptive measures appear to be related to need satisfaction; and the clear value of a multineed conception for measurement and for application to program planning and resource allocation. Suggestions for improvement in measures were made and cross-validation called for.