Wolfe Ingrid, Sigfrid Louise, Chanchlani Neil, Lenton Simon
King's College London, Department of Public Health Sciences and Primary Care, Evelina London Children's Hospital, London, United Kingdom.
University of Oxford, Oxford, United Kingdom.
J Pediatr. 2016 Oct;177S:S217-S242. doi: 10.1016/j.jpeds.2016.04.058. Epub 2016 Sep 22.
Child health in the United Kingdom has improved markedly over recent decades but has failed to match health gains and reductions in mortality achieved by other European countries. Child poverty and inequalities are rising in the United Kingdom. The National Health Service (NHS) is a universally accessible health service, funded by taxation and is free at the point of use. The NHS is undergoing substantial reform, aiming to improve care quality and experience, meet rising demands, and contain costs. The NHS is struggling to balance access with expertise for urgent and unscheduled care. There is increasing use of urgent and emergency care, and there are unexplained variations in outcomes. Quality of care for children and young people with chronic and long-term conditions, including transition services, is variable and sometimes poor. Many determinants of noncommunicable conditions are worsening. Key achievements include a universal service free at the point of use, providing generally accessible, and equitable care. Key challenges include increasing fragmentation of services, insufficient emphasis on preventive care, achieving an effective balance between access and expertise of care for children, and improving child health and well-being outcomes despite generally high quality inputs and high levels of spending.
近几十年来，英国儿童健康状况有了显著改善，但未能达到其他欧洲国家在健康改善和死亡率降低方面的水平。英国儿童贫困和不平等现象正在加剧。国民医疗服务体系（NHS）是一项全民可及的医疗服务，由税收资助，使用时免费。NHS正在进行重大改革，旨在提高护理质量和体验，满足不断增长的需求，并控制成本。NHS在平衡紧急和非预约护理的可及性与专业水平方面面临困难。紧急和急诊护理的使用越来越多，且结果存在无法解释的差异。对患有慢性和长期疾病的儿童和年轻人的护理质量，包括过渡服务，参差不齐，有时甚至很差。许多非传染性疾病的决定因素正在恶化。主要成就包括一项使用时免费的全民服务，提供普遍可及且公平的护理。主要挑战包括服务日益分散、对预防护理重视不足、在儿童护理的可及性和专业水平之间实现有效平衡，以及尽管投入质量普遍较高且支出水平较高，但仍要改善儿童健康和福祉状况。
