Use of Community Health Needs Assessment for Regional Planning in Country South Australia

Abstract

This study examined the impact of community health needs assessments used in country South Australian health service planning between 1995 and 1999. Data were collected from regional health planning officers during a Search Conference and a series of Delphi rounds. The needs assessments were found to vary from regionally to locally driven approaches. Locally driven approaches ensured local involvement but the process was slower and required more effort from the planner. It was also felt that locally driven approaches could exacerbate tension between a community's imperatives and the regional focus of regional decision-makers. In the overall regional budgets, the reallocation of health service funds according to the needs assessment findings was only small because of difficulties in refocusing from traditional clinical services in the short term. In contrast, the impact on health service thinking about population health issues was thought to have been more significant, for example, in the development of regional women's health plans. The use of community health needs assessments was useful, but for greater impact these should not now be so 'broad-brushed', but be more focused on feasible changes that health services could support. Other priority-setting techniques, such as marginal analysis, should also be used to determine where maximum health gains can be obtained.

Developing Targeted Health Service Interventions Using the PRECEDE-PROCEED Model: Two Australian Case Studies

“…A needs assessment is an inexact science with several factors limiting its effectiveness [4, 8, 38]. The PRECEDE-PROCEED Model addresses many of these limitations.…”

“…This model demands that an inclusive process as opposed to tokenism is utilised, which ensures the active involvement of local communities and consumers in identifying, prioritizing, and responding to these needs [4]. As such, the Model prevents the needs assessment process from being ritualistic and self-justifying, by ensuring that the process is focused on facilitating health care reform [8, 38]. Although, undertaking a needs assessment implies that a change is required, there is little evidence that documenting “need” alone actually leads to effective health system change [9].…”

“…In these circumstances, conducting a needs assessment without a commitment to implementing recommended solutions is a lost opportunity to address identified unmet need, resolve issues, and an unnecessary and wasteful strain on scarce resources [6]. The PRECEDE-PROCEED Model challenges health services to change practices and prevents reinforcing a potentially dysfunctional status quo in service or program delivery [4, 8]. This diagnostic method increases the utility of a needs assessment in the real world setting by providing a framework which encourages identification and consideration of the environmental, social, and behavioural factors that may impact on any planned intervention.…”

“…This systematic process facilitates appraisal of a population's health needs, identifies service gaps, the services required and the degree to which the proposed service(s) will be used by those in greatest need [7]. All relevant information, concerning health-related needs, and possible solutions to enable the planning and delivery of cost-effective services or new initiatives are collated [8]. This data enables navigation of a pathway forward, while balancing the clinical, ethical, and economic consideration of “need” [9].…”

Community Views and Public Health Priority Setting

“…Currently there is little published research on the priority setting process in rural communities (Fuller, Bentley, & Shotton, 2001; Horne, Miller, Silva, & Anderson, 2013; Timmons et al, 2007), and no research looking at the potential benefits of adding questions about health concerns and priorities to current health surveys such as the BRFSS. In the current study, we present the results of a community survey on health priorities across a seven-county region of rural New York State, and compare them to county health department priorities and to local health statistics for the region.…”