Goldacre M J, Harris R I
Br Med J. 1980 Dec 6;281(6254):1515-9. doi: 10.1136/bmj.281.6254.1515.
The report of the Resource Allocation Working Party recommended that revenue allocations to health authorities should be based, in part, on national patterns of bed usage and local standardised mortality ratios for conditions aggregated according to the chapters of the International Classification of Diseases (ICD). Similar criteria are now being considered for planning purposes by regions. The extent to which diseases which commonly result in the use of hospital care are also common causes of deaths within their ICD chapter was studied. National utilisation figures show that most beds in ophthalmology, ear, nose, and throat surgery, gynaecology, and consultant dentistry, and an estimated one-third or more of the beds used in general surgery, neurosurgery, and plastic surgery, are used for the treatment of conditions which are uncommon causes of death, both in absolute terms and relative to their ICD chapters. It seems unlikely that the requirements for care of patients with these diseases can be measured simply, either by all-causes mortality statistics, or by the use of mortality statistics ascribed to the ICD chapter which such diseases share with other, more common, causes of death. Consideration needs to be given to the diseases treated by each specialty in deciding whether and how to apply mortality statistics in planning for and funding the specialty.
资源分配工作小组的报告建议，向卫生当局的收入分配部分应基于全国病床使用模式以及根据国际疾病分类（ICD）各章节汇总的疾病的地方标准化死亡率。目前各地区出于规划目的也在考虑类似标准。研究了那些通常导致使用医院护理的疾病在其ICD章节中也是常见死亡原因的程度。全国使用数据表明，眼科、耳鼻喉科手术、妇科和顾问牙科的大多数病床，以及普通外科、神经外科和整形外科使用的病床估计有三分之一或更多，用于治疗那些无论是从绝对数量还是相对于其ICD章节而言都是不常见死亡原因的疾病。对于这些疾病患者的护理需求，似乎不太可能仅通过全因死亡率统计数据，或通过使用归因于这些疾病与其他更常见死亡原因共有的ICD章节的死亡率统计数据来简单衡量。在决定是否以及如何将死亡率统计数据应用于专科规划和资金投入时，需要考虑每个专科所治疗的疾病。
