Hutchinson A, Foy C, Sandhu B
Health Care Research Unit, University of Newcastle upon Tyne.
BMJ. 1989 Nov 4;299(6708):1142-4. doi: 10.1136/bmj.299.6708.1142.
Current proposals in the general practitioner contract include additional payments to doctors working among deprived populations. The underprivileged area score will be used to identify local authority wards with the greatest levels of deprivation, thus acting as the basis for distributing considerable resources. Two methods of identifying deprived populations--the underprivileged area score and the material deprivation score--were compared to determine whether they result in similar allocation of resources to regions. Financial allocations to regions based on figures derived from the contract differed considerably if the material deprivation score was used instead of the underprivileged area score: Northern and Mersey regions gained over 50% of their allocation whereas East Anglia, Oxford, and South West Thames regions lost more than 30% of theirs. Such differences have considerable implications for doctors working among deprived populations as up to 60m pounds each year might be distributed by these payments.
全科医生合同目前的提案包括向在贫困人群中工作的医生额外支付报酬。贫困地区得分将用于识别贫困程度最高的地方政府选区，从而作为分配大量资源的依据。比较了两种识别贫困人群的方法——贫困地区得分和物质匮乏得分，以确定它们是否会导致向各地区分配相似的资源。如果使用物质匮乏得分而非贫困地区得分，基于合同数据对各地区的财政拨款会有很大差异：北部和默西地区获得了超过50%的拨款，而东安格利亚、牛津和泰晤士河南部地区则损失了超过30%的拨款。这些差异对在贫困人群中工作的医生有重大影响，因为这些支付每年可能会分配高达6000万英镑。
