Is counting the dead enough? Strategies for monitoring health needs in New York City.
Determining health care needs--especially unmet needs--in New York City should continue as a research and policy priority, especially in a rapidly changing health care environment. Among the many data sources that can be used in assessing needs are: mortality data; census data; other vital statistics; National Health Interview Survey data; other interview and survey data; physician examination of patients. Among the uses to which these and other data are being put in an effort to determine unmet need and health status are: predicting age-sex-specific demographic, health status, and utilization trends; analysis of sentinel health events; developing hierarchies of need for small areas; development of city and neighborhood "health profiles"; provider determination of needs for program planning. Obstacles to progress persist, however, including the increasing costs of data gathering and analysis; lack of popular or political support for needs assessment; and problems in defining what health care needs are. Among high priorities for those interested in better assessment of health care needs in New York City are: recreating public and political interest in the issue; garnering more financial support for research; countering trends toward privatization and fragmentation of data collection and analysis efforts; new relationships between academic and other researchers; better definition of need and refinement of research methodologies and data bases; development of a clear strategy for assessing health needs in New York City in the future, and garnering broad support for implementing it.
D003625:Data Collection; D003710:Demography; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D009026:Mortality; D009519:New York City / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*; D014505:Urban Population