Towards a theory of perceived and medically defined need

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Abstract
This paper presents a theoretical model to be used for comparative studies of lay and medically defined need for medical care. The model is based on an analysis of the concept of need and need statements, lay and medical concepts of ill health and the relationships between need, ill health and utilization of medical care. It is concluded, on both theoretical and empirical grounds, that need is relative to time, place and assessor. The most important determinants of assessments of for what and when one should seek medical attention are assumed to be the assessor's perception and valuation of the health status and his expectations of the probable out‐come of medical care use. Assessment of need is seen as a process in which past experiences and expectations of the future course of the health status affect decision‐making. It is emphasized that the points of view of both client and provider should be taken into consideration in medical practice, as well as in health care planning, because the two perspectives tend to be only partially congruent. The nature and extent of these incongruences could be studied by the application of the proposed model.

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