title: Geographies of need and the new NHS: methodological issues in the definition and measurement of the health needs of local populations.
abstract: For a variety of purposes it is increasingly necessary to establish the health needs of local populations. Following a critique of existing proxies of need, this paper presents and evaluates an alternative which draws upon epidemiological evidence concerning the age, sex and social class distribution of morbidity in order to estimate the prevalence of specific conditions in designated populations. By way of demonstrating the insights to be gained through the use of these indicative prevalence rates, the paper considers the treatment of ischaemic heart disease in a sample of 539 practices and presents evidence regarding the significance of deprivation and rurality in determining health service use relative to needs.
authors.affiliation: Department of Geography, University of Exeter, Amory Building, Rennes Drive, Exeter EX4 4PN, UK. a.gibson@exeter.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Gibson
authors.forename: S
authors.initials: S
authors.lastname: Asthana
authors.forename: P
authors.initials: P
authors.lastname: Brigham
authors.forename: G
authors.initials: G
authors.lastname: Moon
authors.forename: J
authors.initials: J
authors.lastname: Dicker
mesh_terms: D004812:Epidemiologic Methods; D005843:Geography; D015438:Health Behavior; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D007256:Information Systems; D017202:Myocardial Ischemia / Q000453:epidemiology*; D020380:Needs Assessment; D015995:Prevalence; D012307:Risk Factors; D013222:State Medicine; D006113:United Kingdom / Q000453:epidemiology