Estimates Of Need Research Articles

Need, Demand, and Supply of Medical Care in a Population Sample of Rheumatoid Arthritis

Estimates of medical need in persons with rheumatoid arthritis (RA) are rarely based on data from population surveys. In a population survey of RA in Stockholm City, 293 RA sufferers were identified in four random samples of four age-groups in the adult population, age-range 31-74 years. The influence of age, sex, and severity of disease on the number of pervious hospital admissions was slight, indicating that diagnosis, rather than rehabilitation, is the impetus to hospital admission. Hospital patient inventories might give quite misleading information as to need. Need for hospital admission, out-atient care, reconstructive surgery, ADL-devices, physical therapy, and rehousing were all considered. 17% of the RA group accounted for 48% of the need. Steinbrocker functional classes I and II contributed to 61% of individuals in need of hospital care greatly exceeded those previously having enjoyed such care and possible availabel resources. Estimates of need for outpatient care for joint disease exceeded provided treatment by only 1.7 times. It is concluded that the psychological distance between doctor's decision to choose inpatient or outpatient treatment in the case of RA is generally fairly short. Figures are given for estimates of need based on a population of 100 000 with known age and sex distribution and prevalence of disease.

Estimation of Need, Utilization, and Costs of Personal Care Homes and Home Health Services

Estimation of Need, Utilization, and Costs of Personal Care Homes and Home Health Services

THE RELATIONSHIP OF BEHAVIOR TO ADJUSTMENT IN A REPRESENTATIVE SAMPLE OF CHILDREN.

SUCCESSFUL methods have not yet been developed for the identification of early or mild mental disorders in children. Paradoxically, this lack of success may be closely related to the inability of existing psychiatric facilities to provide services to the children believed to need them. It is quite possible that the root of both problems is to be found in the prevailing variability of diagnostic practices. Differentiation of well persons from those with mild or early signs of mental disorder can hardly be successful when marked diagnostic variations from one psychiatric center to another occur even in cases of florid mental illness.' The failure of efforts to screen borderline psychiatric problems in children is therefore not surprising.2 Early detection cannot actually become feasible until objective criteria commanding a large measure of agreement among diagnosticians are established. By the same token, the true insufficiencies of existing psychiatric services may in fact be grossly overestimated. To some extent, at least, the estimates of present and future needs for these services are related to prevailing diagnostic practices. Overdiagnosis obviously leads to overestimation of needs. The Cornell group, using broad spectrum criteria, found than 25 per cent of their population was severely mentally ill and in need of psychiatric treatment.3 Other investigators at Johns Hopkins, using a narrower spectrum, reported a 10 per cent prevalence rate for a more or less equivalent degree of mental illness.4 Selective Service rates during World War II varied all over the country in accordance with a variety of factors, one of which was diagnostic practice.5 For children's mental disorders, the estimates of need for psychiatric services are also a function of diagnostic practice. When psychopathological significance is attributed to various behavior characteristics such as bedwetting, thumbsucking, and many others, children exhibiting these alleged abnormal behaviors become candidates for psychiatric treatment and perforce enter the competition for psychiatric services. A problem of almost astronomical magnitude exists if such behaviors

A method for measuring physician requirements, with appraisal of former methods.

It is apparent from the literature on health programs that attempts to estimate the manpower necessary to give current and future health services to the American people are of major interest and primary importance. Special study commissions, the press, and the general public have all participated in discussions of the numerical needs for physicians, dentists, nurses, and health personnel. VARIATIONS IN ESTIMATES From most of the available reports one gets the impression that there is a serious shortage of physicians and that the medical schools and health institutions have been remiss in training an adequate supply for the future needs of the country. Some authorities, however, have ventured to estimate a surplus rather than a shortage. There are extremely wide differences in numerical estimates of need. For example, physician manpower estimates vary from a surplus of 6,000 by 1960 to a shortage of 61,000 (see table). The differences in the