Assessing the need for health status measures.

Abstract

The current reorganisation of the NHS obliges health authorities to purchase a pattern of health care provision which accords with the health needs of the local population.'This seemingly unexcep- tionable expectation has revealed considerable uncertainty as to how needs assessment should be carried out in practice.The broad characteristics of the population are reflected in a range of demographic, socioecono- mic and mortality data.While these sources of data offer broad insights into patterns of need, they cannot support more intimate decisions.In particular, they are fundamentally incapable of generating valid measures of morbidity.2Aspects of morbidity are reflected in health services utili- sation data, but their interpretation suffers from the necessary deficiency that patterns of demand and supply are inseparable from patterns of need.Routine data sources are therefore inadequate for determining those attributes of each population that should inform purchasing decisions.Ade- quate needs assessment must depend upon sketching some relief onto this unacceptable void in the portrayal of the population's experience of health and illness.One option which is advocated is the admin- istration of generic measures of health status to samples of the population in the expectation that the resultant profiles and indices may offer a representative view of the perceived need for health care.In this paper we consider the relevance of generic health status measures to

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