Fearn R
Soc Sci Med. 1987;24(3):263-74. doi: 10.1016/0277-9536(87)90053-0.
Discussion over health needs and health care in the U.K. has mainly centered on the urban area. The countryside has not been included in this debate because it is assumed that rural people are healthier than their urban counterparts and that health and social services are more effective. This paper questions these two premises and shows higher than expected levels of illness in the rural area and the health services to be largely dependent on general practice which, like all rural services, is becoming increasingly centralised and inaccessible. What is needed, it is argued, is the construction of a case for more localised care. Not that this should necessarily lead to a singularly rural type of health service, rather that patterns of provision should be adapted to local needs wherever they are situated.
关于英国健康需求与医疗保健的讨论主要集中在城市地区。农村地区并未被纳入这场辩论,因为人们认为农村居民比城市居民更健康,而且健康和社会服务更有效。本文对这两个前提提出质疑,并表明农村地区的疾病水平高于预期,且医疗服务在很大程度上依赖全科医疗,而与所有农村服务一样,全科医疗正变得越来越集中且难以获得。有人认为,需要构建一个支持更本地化医疗的理由。这并非意味着这必然会导致一种单一的农村型医疗服务,而是说无论位于何处,服务提供模式都应适应当地需求。