Need, demand, supply in health care: working definitions, and their implications for defining access

Abstract Effective policymaking in health care systems begins with a clear typology of the terminology – need, demand, supply and access to care – and their interrelationships. However, the terms are contested and their meaning is rarely stated explicitly. This paper offers working definitions of need, demand and supply. We draw on the international literature and use a Venn diagram to explain the terms. We then define access to care, reviewing alternative and competing definitions from the literature. We conclude by discussing potential applications of our conceptual framework to help to understand the interrelationships and trade-offs between need, demand, supply and access in health care.

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What can U.S. dermatology learn from health care systems abroad? An observation of Taiwan’s system of clinical efficiency as a possible model for increased patient access to care and affordability

Dermatology Online Journal ◽

10.5070/d3215027517 ◽

2015 ◽

Vol 21 (5) ◽

Author(s):

Faranak Kamangar ◽

Jillian W Millsop ◽

Dino Tsai ◽

John YM Koo

Keyword(s):

Health Care ◽

Access To Care ◽

Health Care Systems ◽

Patient Access ◽

Clinical Efficiency ◽

Care Systems

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Mental Health Care Funding Systems and their Impact on Access to Psychotherapy

The Oxford Handbook of Psychotherapy Ethics ◽

10.1093/oxfordhb/9780198817338.013.28 ◽

2020 ◽

Author(s):

Joelle Robertson-Preidler ◽

Nikola Biller-Andorno ◽

Tricia Johnson

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Distributive Justice ◽

Health Systems ◽

Health Care Systems ◽

Resource Scarcity ◽

Trade Offs ◽

Health Care Funding ◽

Care Systems

Resource scarcity forces health care systems to set priorities and navigate trade-offs in how they choose to fund different services. Distributive justice principles can help guide health systems to fairly allocate scarce resources in a society. In most countries, mental health care and psychotherapy, in particular, tend to be under-prioritized even though psychotherapy can be an effective treatment for mental health disorders. To create ethical funding systems that support appropriate access to psychotherapy, health care funding systems must consider how they allocate and distribute health care resources through health care financing, coverage criteria, and reimbursement mechanisms. Five health care systems are assessed according to how they finance and reimburse psychotherapy. These health systems use various and often pluralistic approaches that encompass differing distributive justice principles. Although distribution priorities and values may differ, fair and transparent processes that involve all key stakeholders are vital for making ethical decisions on access and distribution.

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Structural Barriers to Diagnosis and Treatment of Cancer in Low- and Middle-Income Countries: The Urgent Need for Scaling Up

Journal of Clinical Oncology ◽

10.1200/jco.2015.61.9189 ◽

2016 ◽

Vol 34 (1) ◽

pp. 14-19 ◽

Cited By ~ 39

Author(s):

Eduardo Cazap ◽

Ian Magrath ◽

T. Peter Kingham ◽

Ahmed Elzawawy

Keyword(s):

Health Care ◽

Access To Care ◽

Cancer Care ◽

Health Care Systems ◽

Diagnosis And Treatment ◽

Middle Income ◽

Health Crisis ◽

Middle Income Countries ◽

Care Systems ◽

Low And Middle Income

Noncommunicable diseases are now recognized by the United Nations and WHO as a major public health crisis. Cancer is a main part of this problem, and health care systems are facing a great challenge to improve cancer care, control costs, and increase systems efficiency. The disparity in access to care and outcomes between high-income countries and low- and middle-income countries is staggering. The reasons for this disparity include cost, access to care, manpower and training deficits, and a lack of awareness in the lay and medical communities. Diagnosis and treatment play an important role in this complex environment. In different regions and countries of the world, a variety of health care systems are in place, but most of them are fragmented or poorly coordinated. The need to scale up cancer care in the low- and middle-income countries is urgent, and this article reviews many of the structural mechanisms of the problem, describes the current situation, and proposes ways for improvement. The organization of cancer services is also included in the analysis.

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Persistent Disparities in Access to Care across Health Care Systems

Journal of Health Politics Policy and Law ◽

10.1215/03616878-2009-020 ◽

2009 ◽

Vol 34 (4) ◽

pp. 635-647 ◽

Cited By ~ 1

Author(s):

Lynn A. Blewett

Keyword(s):

Health Care ◽

Access To Care ◽

Health Care Systems ◽

Care Systems

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Conceptual Framework to Guide Intervention Research Across the Trajectory of Dementia Caregiving

The Gerontologist ◽

10.1093/geront/gnz157 ◽

2020 ◽

Vol 60 (Supplement_1) ◽

pp. S29-S40 ◽

Cited By ~ 2

Author(s):

Dolores Gallagher-Thompson ◽

Ann Choryan Bilbrey ◽

Ester Carolina Apesoa-Varano ◽

Rita Ghatak ◽

Katherine K Kim ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Conceptual Framework ◽

Longitudinal Research ◽

Health Care Systems ◽

Care Recipient ◽

Sociocultural Factors ◽

Care Needs ◽

Dementia Caregiving ◽

Care Systems

Abstract This article presents a comprehensive conceptual framework designed to foster research in the changing needs of caregivers and persons with dementia as they move through their illness trajectory. It builds on prior theoretical models and intervention literature in the field, while at the same time addressing notable gaps including inadequate attention to cultural issues; lack of longitudinal research; focus on primary caregivers, almost to the exclusion of the person with dementia and other family members; limited outcome measures; and lack of attention to how the culture of health care systems affects caregivers’ quality of life. The framework emphasizes the intersectionality of caregiving, sociocultural factors, health care systems’ factors, and dementia care needs as they change across time. It provides a template to encourage longitudinal research on reciprocal relationships between caregiver and care recipient because significant changes in the physical and/or mental health status of one member of the dyad will probably affect the physical and/or mental health of the partner. This article offers illustrative research projects employing this framework and concludes with a call to action and invitation to researchers to test components, share feedback, and participate in continued refinement to more quickly advance evidence-based knowledge and practice in the trajectory of dementia caregiving.

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