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Community needs assessment in family medicine

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

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Community needs assessment in family medicine

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  1. 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

  2. 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

  3. 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

  4. 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?

  5. 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

  6. 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

  7. 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

  8. 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.

  9. Measuring success of needs assessment • Did we obtain useful data? • Did this allow us to design an intervention? • Did the intervention improve health?

  10. 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

  11. 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?

  12. Conclusion • The role of community health needs assessment begins and ends with a clear understanding our profession, ourselves, our patients and our shared objectives.

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