A needs assessment strategy for an era of limited resources

Among the several methods of assessing need for health services, the social indicator and the rates under treatment approaches utilize routinely available data. A well designed community survey, considered by many as the criterion of need within an area, is costly, difficult to mount, and requires considerable expertise. Therefore, it would seem reasonable to attempt to limit the need to utilize this approach. Presented here is a schema which utilizes the social indicator and rates under treatment approaches for an entire catchment area, reserving the survey approach only for those areas in which the two readily available need assessments are at variance, suggesting questionable validity for one or both approaches. Within a suburban middle-class county containing pockets of small town poverty, a social area analysis was undertaken to characterize need for mental health services. Inpatient rates under treatment were developed to measure demand. Key informant and survey approaches were undertaken to study selectively those census tracts which were discordant as to need and demand. This resulted in reducing the size of the population to be surveyed to 25 per cent of the total county, thus more efficiently using the limited resources available for needs assessment purposes.