Division of Hospital Medicine, University of California-San Francisco, San Francisco, CA 94143, USA.
Int J Health Serv. 2013;43(3):567-85. doi: 10.2190/HS.43.3.l.
Need is a pivotal concept within health systems internationally given its driving force in health care policy, development, and delivery at population and individual levels. Needs assessments are critical activities undertaken to ensure that health services continue to be needed and to identify new target populations that demonstrate unmet need. The concept of need is underpinned by varied theoretical definitions originating from various disciplines. However, when needs are assessed, or health interventions developed based on need, little, if any, detail of the theoretical or conceptual basis of what is being measured is ever articulated. This is potentially problematic and may lead to measurement being invalid and planned health services being ineffective in meeting needs. Seldom are theoretical definitions of need ever compared and contrasted. This critical review is intended to fill this gap in the literature. Interpretations of the concept of need drawing from areas such as psychology, social policy, and health are introduced. The concept and relevance of unmet need for health services are discussed. It is intended that these definitions can be used to operationalize the term "need" in practice, theoretically drive needs assessment, and help guide health care decisions that are based upon need.
需要是国际卫生系统中的一个关键概念，因为它是医疗保健政策、发展和在人群和个人层面提供服务的驱动力。需求评估是确保卫生服务继续得到需求和确定新的目标人群以满足未满足需求的关键活动。需要的概念是由来自不同学科的各种理论定义支撑的。然而，当进行需求评估或根据需求制定卫生干预措施时，很少有（如果有的话）详细说明正在测量的理论或概念基础。这可能是有问题的，并且可能导致测量无效，计划的卫生服务无法满足需求。需要的理论定义很少被比较和对比。本批判性评论旨在填补文献中的这一空白。本文从心理学、社会政策和健康等领域引入了对需要概念的解释。讨论了卫生服务未满足需求的概念和相关性。我们希望这些定义可用于在实践中使“需要”一词具体化，从理论上推动需求评估，并帮助指导基于需要的医疗保健决策。
