'A remarkably simple and helpful piece of research' Chris Mullin, Chief Economist, UK Department of Health and Social Care This quote was among a number of twitter postings that commented on the publication of the paper reporting work undertaken by Idaira Rodriguez Santana and collaborators from the Centre from Health Economics (CHE) at University of York.

The paper was published on 12th October in the journal ‘Health Economics, Policy and Law’ (Need, demand, supply in health care: working definitions, and their implications for defining access | Health Economics, Policy and Law | Cambridge Core).

The paper contributes to the need for clear typology of terminology employed in effective policy making across all health care systems. By drawing upon the international literature and employing a Venn diagram, the authors explicitly explain these terms. The authors go on to define access to care by reviewing alternative and competing definitions from the literature. The paper concludes by discussing potential applications of the conceptual framework presented in the paper to help understand the relationships and trade-offs between need, demand, supply and access in health care.

In his tweet, Chris Mullin, stated ‘health policy is tricky enough, so we can do without the confusion caused by misuse of terms like need, demand and supply. This is a remarkably simple and helpful piece of research.’ Chris Mullin leads more than 300 professional analysts, with responsibility for ensuring the UK Government's policies across health and social care are informed by rigorous analysis, statistics, data and evidence. Chris has held the post of Chief Economist at the UK Department of Health and Social Care since 2016,

The Venn diagram used to illustrate the authors conceptual framework, represented health care need, demand and supply in three coloured circles drawing upon earlier similar graphical representations used in the needs assessment literature to illustrate drivers of and indicators for need, demand and supply. The literature includes work by  Stevens and Gabbay,Wright et al and Stevens, Raftery, Mant and Simpson. The authors confirm that their application has a similar goal to work published by Hurley in 2010, to highlight areas for policy attention such as unmet need, inefficiency  and inappropriate demand.

The authors state that their conceptual framework is a tool for understanding the types of health care that providers supply and patients demand to meet their health care needs, and also a tool for categorising different types of unmet need. The framework sheds light on the trade-offs between the elements of need, demand and supply, and informs debate about when access and utilisation occur.

Application of the framework includes, informing the policy debates on the reallocation of resources and appropriate use of existing health care services, revealing  the potential to help to manage future demand for health care by reallocating resources to address need for health care that can improve health in the future, improving information for patients and the public and exploration for how these considerations vary by social group or other patient characteristics such as age, gender, ethnicity, clinical condition. In their conclusion Idaira and co-authors state that the proposed working definitions they offer for need, demand, supply and access are intended to provide a conceptual framework for thinking about, organising and potentially monitoring resources to ensure population health care needs are addressed in the most efficient and equitable way for a given set of resource constraints.

Idaira leads the Spanish office of HCD Economics and is involved in a range of research and analysis projects for HCD Economics which contribute to the evidence used in informing health care decisions and policy that contributes to the setting of healthcare resource allocation. Idaira joined HCD Economics following the conclusion of her post-graduate research with the University of York.

For more information on the research published in this paper please contact idaira.rodriguez@hcdeconomics.com. For a broader overview of the research being undertaken by HCD Economics in support of efficient and equitable of healthcare resource allocation, please contact alison.rose@hcdeconomics.com.