[Health resources allocation in Canada provinces: the role of indicators of health needs]

In an attempt to limit their health care expenditures Canadian provinces have strengthened the necessity to allocate health care resources according to their population needs. The difficulties and limitations of the needs-based approach are explored. First, indicators of population needs for health care were introduced into a formula of resource allocation for hospital-based services in England in the late 1970. Secondly, there are broad similarities between both the philosophy and resource allocation strategies of Canada and Britain. Thirdly, the main definition of a needs indicator is to measure the level of equity- or inequity-in the distribution of health care resources between regions. Fourthly, a needs indicator, as least as developed by the Canadian provinces, concerns general and specialized services that should be found in each of their regions. Fifthly, a needs indicator constitutes a tool for the calculation of a capitation rate. Finally, future research should focus on parameters which are not an integral part of the allocation method, but which have a strong impact, in the attainment of regional equity such as administrative decisions that are taken when budgets are to be allocated or reduced between regions.