Measurement of problem-oriented need for the primary health care services: need for exercise counseling as an example

Based on several previous approaches, a new model for the measurement of needs for primary health care services is constructed and demonstrated. This fourfold model includes the concepts of diagnostic need, perceived need, client dependent demand and provider dependent demand. The empirical results concerning the need for exercise counseling in the primary health care indicated that the present approach is feasible and comprehensive enough to obtain valuable information about the health needs and how they are supplied. The model makes it possible to identify discrepancies, for example, between the experts' and clients' priority ratings and between the criterion-based prevalence of a problem and the practice of the care providers. It may also reveal barriers and inequalities in the use of services. For health administrators and decisionmakers the present problem-oriented model provides a systematic approach to assess needs for health care services and to develop the services provided.