NEED AND DEMAND FOR PRIMARY HEALTH-CARE - A COMPARATIVE SURVEY APPROACH

Objective-To develop general practice profiles of needs and demand for primary health care. Design-Postal survey of a stratified random samp le of 3478 people registered with five general practices. Data from a single practice were compared with data from the remaining four to ide ntify areas of comparative need. Setting-Five general practices in Lot hian. Main outcome measures-Differences between the single practice an d the comparison practices in terms of social and economic circumstanc es, limiting long term illness, specific ongoing conditions, minor ill ness or symptoms, psychosocial problems, discussion of lifestyle, asso ciated use of services. Results-Respondents from the single practice r eported higher rates than those in the four comparison practices of on going mental health and respiratory problems and use of antidepressant s, tranquillisers, or sleeping tablets. Although rates of limiting lon g term illness and other specific ongoing conditions were comparable, the rates of minor illness or symptoms and psychosocial difficulties w ere higher in the single practice. Respondents from the single practic e were more likely to consult frequently, to have contacted the practi ce out of normal working hours, and to have discussed psychosocial dif ficulties with a general practitioner. For any specific ongoing condit ion or ''minor'' illness, respondents from the single practice were no more likely to consult. Conclusions-A comparative survey approach is a useful method of developing an understanding of patterns of need and demand among general practice populations. It has the potential to in form planning within individual general practices and the process of c ommissioning among general practices within a given area.