Glendinning Caroline, Clarke Susan, Hare Philippa, Maddison Jane, Newbronner Liz
Social Policy Research Unit, University of York, York, UK.
Health Soc Care Community. 2008 Jan;16(1):54-63. doi: 10.1111/j.1365-2524.2007.00724.x.
Social care services for adults are increasingly required to focus on achieving the outcomes that users aspire to, rather than on service inputs or provider concerns. This paper reports a study aimed at assessing progress in developing outcomes-focused services for older people and the factors that help and hinder this. It describes the current policy context and discusses the social care service outcomes desired by older people. It then reports on a postal survey that identified over 70 outcomes-focused social care initiatives across England and Wales, and case studies of progress in developing outcomes-focused social care services in six localities. The study found progress in developing outcomes-focused services was relatively recent and somewhat fragmented. Developments in intermediate care and re-ablement services, focusing on change outcomes, were marked; however, there appeared to be a disjunction between these and the capacity of home care services to address desired maintenance outcomes. Process outcomes were addressed across a range of re-ablement, day care and residential services. The paper concludes by discussing some of the challenges in developing outcomes-focused social care services.
成人社会护理服务越来越需要专注于实现用户所期望的成果，而不是服务投入或提供者所关心的问题。本文报告了一项研究，旨在评估为老年人开发以成果为导向的服务方面的进展情况以及有助于和阻碍这一进展的因素。它描述了当前的政策背景，并讨论了老年人期望的社会护理服务成果。然后报告了一项邮政调查，该调查确定了英格兰和威尔士70多项以成果为导向的社会护理举措，以及六个地区在开发以成果为导向的社会护理服务方面的进展案例研究。研究发现，开发以成果为导向的服务方面的进展相对较新且有些零散。侧重于改变成果的中级护理和恢复服务有显著发展；然而，这些服务与家庭护理服务满足期望的维持成果的能力之间似乎存在脱节。在一系列恢复服务、日托服务和住宿服务中都涉及了过程成果。本文最后讨论了开发以成果为导向的社会护理服务所面临的一些挑战。
