Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford Royal Imfirmary, Duckworth Lane, Bradford BD9 6RJ, UK.
Arch Gerontol Geriatr. 2009 Dec;49 Suppl 2:S21-5. doi: 10.1016/S0167-4943(09)70008-1.
The origins of intermediate care as a health policy in England are reviewed. The randomized controlled trial (RCT) evidence for the various intermediate care service models is discussed from the perspectives of clinical, service and economic outcomes. This evidence base suggests that the hospital-at-home approach is currently the best RCT supported intermediate care service model. It is argued that intermediate care in England has yet to fulfil its expectations. Changing staff skills and attitudes has proved a challenge, and the integration of intermediate care with mainstream services has been especially difficult. New national guidance has been produced that is attempting to refocus intermediate care its intended target group of frail older people, and not to specifically exclude older people with mental health problems.
本文回顾了英国将中级护理作为一项卫生政策的起源。从临床、服务和经济结果的角度讨论了各种中级护理服务模式的随机对照试验（RCT）证据。该证据基础表明，目前医院居家模式是最有 RCT 支持的中级护理服务模式。有人认为，英国的中级护理尚未达到预期效果。改变员工的技能和态度一直是一个挑战，而且中级护理与主流服务的融合尤其困难。已经制定了新的国家指导方针，试图将中级护理重新聚焦于其预期的体弱老年人目标群体，而不是特别排除有心理健康问题的老年人。
