by: Dr.Ajitendra, MHA-Health
Demand is an economic concept which describes the quantity of a good or service per unit time that an individual or household will purchase and consume at given price of goods or services. It is distinct from need which, in the context of health- can be seen as the level of health services which a medical specialist finds necessary to meet particular health indicator. When demand and need do not coincide the real problem surfaces.
When individuals demand for health services that medical specialist suggests they do not need, it causes waste of resources. On the other hand if individuals do not demand health services, which they medically require, it will lead to worsening of their health and if that disease is communicable, then of others too.
Concept of shortage: Both for Poor and Rich
“Rich: ever-growing demands not met”
“Poor: basic needs not met”
Apparently, market forces can’t provide the needed health care at affordable prices. Hence the government has to intervene to keep medical services within the reach of vulnerable poor and restore equity.
In rural areas, the need is very high, but demand or the purchasing parity is quite low, thus it results in lower supply. On the other hand stands the ultra modern urban city, where the demand has far more exceed the need and hence there is a continuous supply of medical care. The gap between urban and rural and the ‘haves’ and ‘have-nots’ is increasing as 75% of India’s health infrastructure & medical manpower are located in urban areas, where only 27% of population resides. Also largely preventable contagious and water borne diseases cause over twice number of death per year in rural areas than urban areas and immunization rates, pattern of delivery, IMR, MMR and other health indicator are skewed in rural areas.
This disparity clearly indicates the restructuring of workforce and other resources according to the need of people rather than demand. For better management and to achieve a more rational distribution of health care resources, one has to clearly distinguish between Demand and need and set the priority to meet 'Need' and tame 'Demand'.
