Murie J, Hanlon P, McEwen J, Russell E, Moir D, Gregan J
Health Centre, South Vennel, Lanark.
Br J Gen Pract. 2000 Jan;50(450):17-20.
Health needs assessment can guide the appropriate shift to primary care by identifying the most effective and efficient resource allocation to meet the needs of populations. Assessing health care needs will be a continuing challenge for primary care trusts in Scotland (or equivalent groups in other parts of the United Kingdom); however, lessons must be learned from the experience of needs assessment that followed the 'internal market' reforms of the 1990s.
To examine general practitioners' (GPs') awareness and experience of needs assessment, to identify barriers to needs assessment in primary care, and to ascertain how better progress might be made in the future.
A postal questionnaire survey of 1777 Scottish GPs (a one-in-two sample) was combined with a semistructured interview survey of 'lead' GPs from a random sample of 64 mainland Scottish practices between May and August 1996.
Sixty-five per cent (1154) of GPs responded to the questionnaire, of which 54% (965) were completed. Over 73% (47) of interviews were completed. Most GPs were unfamiliar with the concept of needs assessment and there was no evidence that needs assessment had influenced commissioning decisions. Most GPs argued that it was not a 'core' activity and that they lacked training in the relevant skills. While the attitude of the majority was indifferent, cynical, and sometimes hostile, a minority, comprising mostly younger fundholders, was more enthusiastic about needs assessment.
The motivation and attitude of the majority of GPs present a barrier to needs assessment in primary care. GPs will require more resources and training if they are to undertake this responsibility. Most GPs believe than incentives (financial or organisational) will be necessary. Primary care trusts and equivalent structures should be aware of these attitudes as they seek to establish plans based on estimates of population needs in defined locations.
健康需求评估可通过确定最有效和高效的资源分配以满足人群需求，来指导向初级保健的适当转变。对苏格兰的初级保健信托基金（或英国其他地区的同等机构）而言，评估医疗保健需求将是一项持续的挑战；然而，必须从20世纪90年代“内部市场”改革后的需求评估经验中吸取教训。
考察全科医生对需求评估的认识和经验，确定初级保健中需求评估的障碍，并确定未来如何能取得更好的进展。
1996年5月至8月，对1777名苏格兰全科医生（二分之一抽样）进行了邮寄问卷调查，并对来自苏格兰大陆64家诊所随机样本中的“带头”全科医生进行了半结构化访谈调查。
65%（1154名）的全科医生回复了问卷，其中54%（965份）填写完整。超过73%（47份）的访谈完成。大多数全科医生不熟悉需求评估的概念，没有证据表明需求评估影响了委托决策。大多数全科医生认为这不是一项“核心”活动，且他们缺乏相关技能的培训。虽然大多数人的态度冷漠、愤世嫉俗，有时甚至怀有敌意，但少数人（主要是年轻的资金持有医生）对需求评估更感兴趣。
大多数全科医生的积极性和态度对初级保健中的需求评估构成了障碍。如果全科医生要承担这项责任，他们将需要更多资源和培训。大多数全科医生认为激励措施（财务或组织方面）将是必要的。初级保健信托基金及同等机构在寻求根据特定地点人群需求的估计制定计划时，应了解这些态度。
