By M. Alderson, R. Dowie and W. F. Maunder (Auth.)
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Other sociological opinions on this topic have been expressed by Parsons [B 366] and Mechanic [B 315, 316, 317, 318]. In a pragmatic contribution Fry [B 203], who used a different definition of 'wants'/'needs'/'resources', distinguished six levels of health and disease: health; presymptomatic phase; phase of symptoms; general practitioner care; specialist care; ultra-specialist care. He emphasized that actions and decisions have to be taken at each threshold and that these depend on the individual's attitudes and family background, local cultural habits, the organization of medical care, and social and administrative issues.
Other sets of statistics relate to specific problems such as Industrial or Road Traffic Accidents. The bulk of this material is published as routine reports from the DHSS and Office of Population Censuses and Surveys (OPCS); as with the mortality data, these have been covered in the previous review [B 14]. The main source of data recently added in this field has been the second National Morbidity Study (NMS); this has collected data on the reported ailments for a sample of about 300,000 people contacting their family doctor over a period of a year.
This is predominantly due to the lack of definitive studies and the tendency to use other data as 'indicators' of need. It will be obvious that a lot of the assessments of need are subjective—determined by the views of the patients or professionals. A number of authors have discussed the use of indicators of need, which are often derived from routine data, faut de mieux. Rosser and Watts [B 396] tested a method for assessing the health status of patients on admission to and discharge from hospital.