Lunt B, Hillier R
Br Med J (Clin Res Ed). 1981 Aug 29;283(6291):595-8. doi: 10.1136/bmj.283.6291.595.
Since 1975 hospices and other specialist services for terminal cancer have expanded rapidly. In December 1980 this survey found 72 such services in Britain providing 58 inpatient units, 32 home care teams, and eight hospital support teams. Many were outside the NHS. Inpatient units provided 1297 beds (modal size 21-25 beds) and dealt with under 7% of deaths from cancer. Home care teams provided 76.5 full-time equivalent nurses (modal size two nurses). Regional variations were considerable: from 10.9 beds/million population in Trent to 48.5 beds/million in South-west Thames; no home care nurses in Mersey and Wales, and 5.1 nurses/million in Wessex. Of 58 more services being planned, the 17 starting in 1981 will not substantially alter these regional imbalances. Respondents' opinions suggest a target of 40-50 inpatient unit beds/million population. This might be reduced if hospitals were better equipped to deal with these patients. Suggested priorities are to redress regional inequalities, develop home care and hospital support teams rather than inpatient units, and improve teaching and training. Co-ordination of plans between the NHS and the voluntary sector is needed.
自1975年以来，临终关怀机构及其他针对晚期癌症的专科服务迅速发展。1980年12月的这项调查发现，英国有72项此类服务，提供58个住院单元、32个家庭护理团队和8个医院支持团队。许多服务不在国民保健制度（NHS）范围内。住院单元提供了1297张床位（平均规模为21至25张床位），处理的癌症死亡病例不到7%。家庭护理团队提供了相当于76.5名全职护士的人力（平均规模为两名护士）。地区差异相当大：特伦特地区每百万人口有10.9张床位，而泰晤士河西南部地区为每百万人口48.5张床位；默西和威尔士没有家庭护理护士，而韦塞克斯地区为每百万人口5.1名护士。在计划开展的58项以上服务中，1981年开始的17项服务不会大幅改变这些地区不平衡状况。受访者的意见表明，目标是每百万人口有40至50个住院单元床位。如果医院有更好的设备来处理这些患者，这一目标可能会降低。建议的优先事项是纠正地区不平等、发展家庭护理和医院支持团队而非住院单元，以及改善教学和培训。国民保健制度和志愿部门之间需要协调计划。
