Macfarlane Alison J, Godden Sylvia, Pollock Allyson M
Department of Midwifery, City University, London EC1Y 4TY, UK.
J Public Health (Oxf). 2005 Sep;27(3):263-9. doi: 10.1093/pubmed/fdi035. Epub 2005 Jun 17.
The NHS plan announced sustained increases in funding accompanied by wide ranging reform, the success of which would be measured by targets set across the board, including increases in numbers of beds, staff, hospitals and equipment. In this article we assess progress towards the target of 7,000 extra beds in hospitals and intermediate care to be achieved by 2004. Summary points are as follows. (1) Although the 2003/2004 target for availability of general and acute NHS beds in England was achieved, the increase did not offset the overall decrease in all categories of beds. Bed availability fell by 2083, from 1,86,290 in 1999/2000 to 1,84,207 in 2003/2004, following a fall of 12,558 from 1996/1997 to 1999/2000. (2) Lack of standardized definitions and data collection systems both within the NHS and for the independent sector, compounded by ambiguity over the funding of extra capacity for the NHS, call into question the accuracy of data collected about intermediate care beds. (3) Systems for collecting data about intermediate care should be made subject to the same code of practice as official NHS statistics in order to monitor future targets and plan for provision of care. (4) Changes in definitions, lack of detail about criteria used in setting targets and lack of data about private sector care, make it impossible to monitor the overall capacity available to the NHS and assess whether bed availability targets have been met.
国民保健服务计划宣布持续增加资金,并进行广泛改革,其成功将通过全面设定的目标来衡量,包括病床数量、工作人员、医院和设备的增加。在本文中,我们评估了到2004年在医院和中级护理方面额外增加7000张病床这一目标的进展情况。要点如下:(1)尽管英格兰国民保健服务体系中普通和急症病床的2003/2004年度可用目标得以实现,但增加的数量并未抵消各类病床总数的下降。病床可用数量减少了2083张,从1999/2000年度的186290张降至2003/2004年度的184207张,而在1996/1997年度至1999/2000年度期间已减少了12558张。(2)国民保健服务体系内部以及独立部门缺乏标准化定义和数据收集系统,再加上国民保健服务体系额外容量资金方面的模糊性,使得关于中级护理病床收集的数据的准确性受到质疑。(3)为监测未来目标和规划护理服务,收集中级护理数据的系统应遵循与国民保健服务官方统计相同的业务守则。(4)定义的变化、设定目标所用标准缺乏细节以及私营部门护理数据的缺失,使得无法监测国民保健服务体系的总体可用容量,也无法评估病床可用目标是否已实现。