community needs assessment in family medicine
DESCRIPTION
Community needs assessment in family medicine. Dr. Yonah Yaphe Department of Family Medicine Rabin Medical Centre and Sackler Faculty of Medicine Tel Aviv University, Israel. Objectives. At the end of this presentation the learner will: Understand the concept of community needs - PowerPoint PPT PresentationTRANSCRIPT
Community needs assessment in family medicine
Dr. Yonah YapheDepartment of Family Medicine
Rabin Medical Centre andSackler Faculty of MedicineTel Aviv University, Israel
Objectives At the end of this
presentation the learner will: Understand the
concept of community needs
Know how to assess these needs
Value the importance of needs assessment
Definitions Community – the context of
the practice Effect of setting – inner city,
suburban, rural Effect of organization – Fee
for service, capitation, salary, fixed list, free choice
Needs – requirements of the population for good health – well-being and function
Needs vs. wants – affordable, accessible, affable care
The nature of community needs
Are community needs the sum of individual needs or is there something more?
Is this a collective or an individual responsibilty?
Who is responsible for the health effects of poverty, poor education, malnutrition, pollution, social alienation and violence?
Who is responsible for the effects of lifestyle and habits like smoking, alcohol, drugs or unsafe driving?
Approaches to assessing needs
Indicators of health – quality of life, indicies of function
Measures of diseases – morbidity, mortality, life expectancy, incidence and prevalence of diseases
Measures of use of services – admission rates, clinic visiting rates
Methods of assessing needs
Health survey – community-wide, inclusive of all conditions or selective
Case finding – based on clinic visitors
Use of existing data Epidemic surveillance Long interviews Focus groups
Examples of community needs assessment
Kiryat Hayovel community health centre, Jerusalem Israel, 1963-1998
Affiliated with the Department of Social Medicine of the Hadassah-Hebrew University Medical School
CHAD – Community syndrome of coronary artery disease, hypertension, and diabetes
PROD – Program for child development
Problems with needs assessment
Community participation – real or sham?
Social engineering Conflict between
individual and collective needs and rights
Health surveys miss the point – Experience with Ethiopian immigrants to Israel
Labor intensive programs divert energies from real needs.
Measuring success of needs assessment
Did we obtain useful data?
Did this allow us to design an intervention?
Did the intervention improve health?
Impact on the daily work of the family doctor or trainee
Keep a chronic disease register
Perform visit registration
Perform epidemic surveillance
Audit your practice Do original research
Discussion The struggle is to use our
limited resources (time, manpower, energy, money) in the most effective way possible.
Will community needs assessment help us?
It depends on how we see our practice and our objectives:
Reducing mortality or admissions?
Change in behaviour? Improving quality of life or
function? Change in health quality
indicators?
Conclusion The role of
community health needs assessment begins and ends with a clear understanding our profession, ourselves, our patients and our shared objectives.