Yule B F
Int Dent J. 1984 Sep;34(3):219-23.
The issue of alternative definitions of need has recently received attention in the dental literature. However, a number of important questions have gone unanswered. Why is it necessary to assess needs; who is to do the assessing and in what decision making contexts are needs to be assessed? This paper presents an economic rationale for assessing needs. Scarcity necessitates choices as to how resources will be used, and it is only by identifying needs and the costs of meeting them that such choices can be made rationally and explicitly. Three levels of decision making are distinguished, together with three assessors of need: patients, dentists and society. It is argued that decisions to seek care and to comply with professional instructions will ultimately rest with patients, whereas decisions as to which individual patients should be given treatment of what type will inevitably lie with the dental profession. In the latter case it is particularly important that dentists' judgements should reflect the social context of their decision making. At a wider community level, it is suggested that dental care professionals have a major role to play in assessing the potential for improvements in the oral health of the population, while the task of making societal decisions as to which needs ought to be met is essentially that of policy makers. Once the legitimate roles of various parties in assessing needs in different decision settings have been established, the concept of need has a key contribution to make to the planning and provision of dental care services.
需求的替代定义问题最近在牙科文献中受到了关注。然而，一些重要问题尚未得到解答。为什么有必要评估需求；谁来进行评估以及在哪些决策背景下需要评估需求？本文提出了评估需求的经济原理。资源稀缺使得必须对资源的使用方式做出选择，只有通过识别需求以及满足这些需求的成本，才能合理且明确地做出此类选择。区分了三个决策层次，以及三种需求评估者：患者、牙医和社会。有人认为，寻求治疗和遵守专业指示的决定最终将由患者做出，而对于哪些个体患者应接受何种类型治疗的决定必然由牙科专业人员做出。在后一种情况下，牙医的判断应反映其决策的社会背景尤为重要。在更广泛的社区层面，有人建议牙科护理专业人员在评估人群口腔健康改善潜力方面发挥主要作用，而做出关于应满足哪些需求的社会决策的任务本质上是政策制定者的任务。一旦确定了各方在不同决策环境中评估需求的合理角色，需求概念对于牙科护理服务的规划和提供将起到关键作用。
