Health care need : Meaning and measurement

Abstract: Determining how the health services are to be, and allocating health care, are basic issues in health policy. Need is a frequent criterion for an ethical or rational allocation of health service resources. The primary aim of this study is to analyse and explicate the concept of health care need.Methods for measuring health care need are examined. Current views on the concept of health care need are analysed. The results generate questions about the logical structure of the concept of need. The analysis of this concept shows that need is instrumental. The thing needed is necessary for a certain goal. The significance of this goal is pointed out. It determines the object of need. The significant goal in the case of health care need is health. The study espouses a holistic theory of health where health is defined in terms of ability to realize vital goals. It is pointed out that 'health' is a value-laden concept and that it bears with it this value-load to the concept of health care need.The concepts of health care, prevention and promotion are analysed. They are distinguished according to the actions involved. Health care means improving a state of ill health. Prevention means avoiding a state of ill health. Promotion means enhancing or supporting a healthy state.Assigning priority to certain needs is necessary in a situation where the health service resources are scarce. The theoretical platform for the setting of priorities in accordance with need is examined. Seven dimensions for a ranking of health care needs are identified. Finally some implications for an assessment of health care need are discussed, and a model for such an assessment is sketched.