Bevan G, Charlton J
Department of Community Medicine, United Medical School, St Thomas's Campus, London.
Br Med J (Clin Res Ed). 1987 Sep 26;295(6601):764-7. doi: 10.1136/bmj.295.6601.764.
The Resource Allocation Working Party (RAWP) recognised the need to consider both health authority and primary care services in achieving its objective. RAWP and the subsequent Advisory Group on Resource Allocation (AGRA) found (but did not publish) considerable variation in resources used by both services but could not find a clear relation between them. Statistics provided by the DHSS were used to compare spending by 80 area health authorities in 1980-1 with expenditure per head on general medical services by their corresponding family practitioner committees. There was considerable variation in the provision of resources for both services and no clear relation between the variations in spending on each service. Only 40 of the 80 areas had both health authority and family practitioner committee spending levels within 10% of "target." Subregional inequalities in resources tend to be related to variations in admission rates, which in turn are related to general practitioners' referral behaviour. These results emphasise the importance of finding out more about inequalities in the provision of general medical services and their relation to the use of hospital services. They also suggest that RAWP's aim of equality of opportunity of access to health care resources may be achieved only if general medical services are brought into the equation as well.
资源分配工作小组（RAWP）认识到，在实现其目标的过程中，需要同时考虑卫生当局和基层医疗服务。RAWP以及随后的资源分配咨询小组（AGRA）发现（但未公布），这两种服务所使用的资源存在相当大的差异，但未能找到它们之间的明确关系。卫生与社会保障部提供的统计数据被用于比较1980 - 1981年80个地区卫生当局的支出与相应家庭医生委员会在普通医疗服务上的人均支出。这两种服务在资源提供方面存在相当大的差异，而且每种服务支出的差异之间没有明确的关系。80个地区中只有40个地区的卫生当局和家庭医生委员会的支出水平在“目标”的10%以内。次区域资源不平等往往与住院率差异有关，而住院率差异又与全科医生的转诊行为有关。这些结果强调了进一步了解普通医疗服务提供方面的不平等及其与医院服务使用之间关系的重要性。它们还表明，只有将普通医疗服务纳入考量，RAWP关于平等获得医疗资源机会的目标才有可能实现。
