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18 Health Econ. Pol'y & L. 1 (2023)

handle is hein.journals/hecpol18 and id is 1 raw text is: Health Economics, Policy and Law (2023), 18, 1-13 doi:10.1017/S1744133121000293 A R1T' LE Idaira Rodriguez Santana' , Anne Mason2* , Nils Gutacker2 , Panagiotis Kasteridis2 Rita Santos2 and Nigel Rice2 1HCD Economics, The Innovation Centre, Warrington, UK and 2Centre for Health Economics, University of York, York, UK *Corresponding author. Email: anne.mason@york.ac.uk (Received 17 December 2020; revised 5 August 2021; accepted 6 August 2021; first published online 12 October 2021) 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. Hm ever, the terms are contested and their meaning is rarely stated explicitly. This paper offers weorking definitions of need, demand and supply. We draw on the international literature and use a \ enn diagram to explain the terms. We then define access to care, reviewting alternative and competing definitions from the literature. We con- clude by discussing potential applications of our conceptual frameweork to help to understand the inter- relationships and trade-offs bet een need, demand, supply and access in health care. Keywords: Health services needs and demand; health services accessibility Effective policymaking and the efficient management of a health care system begin with a clear typology of the terminology - need, demand, supply and access - and their interrelationships. However, the terms are contested and their meanings are rarely stated explicitly (Williams, 1974; Culyer, 2012; Aragon et al., 2017; Mason et al., 2019). Understanding the need for health care, and how this differs from the need for health that underpins it, is an important step towards quantifying current demand for health care and its future trends. It also supports decisions on the amount and type of resources the health care sys- tem requires, such as the medical and non-medical workforce and infrastructure (supply). Informed by a review of the relevant literature, this paper offers working definitions of need, demand and supply of health care. Historically, the academic debate on concepts such as need and access has been motivated by concerns about inequities in the use of health care, e.g. differ- ences in the consumption of health care that are not explained by differences in the need for health care (Aday and Andersen, 1974; Culyer and Wagstaff, 1993; Allin et al., 2010). Like these studies, our starting point is that good health is necessary for a person to flourish (Culyer and Wagstaff, 1993) and may be viewed as a fundamental human right (UN General Assembly, 1966). However, unlike previous studies, our motivation for defining the terms is to consider broader questions about what health care to deliver, how much to deliver, where and how to deliver care, as well as for whom. The paper is structured as follows. We use a Venn diagram to illustrate the conceptual inter- relationships between the three health care elements; need, demand and supply, and the seven distinct areas created by their intersection. We then define each of the three elements, including © The Author(s), 2021. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecomrnons.org/licenses/bv/4.0/), which permits unrestricted re-use, distribution, and reproduc- tion in any medium, provided the original work is properly cited.