Impallomeni M, Starr J
Division of Geriatric Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.
J Public Health Med. 1995 Jun;17(2):171-8. doi: 10.1093/oxfordjournals.pubmed.a043089.
The NHS and Community Care Act 1990, implemented from 1 April 1993, was expected to alter profoundly the provision of domiciliary services to old people. This change needs to be compared with what would have happened if no action had taken place. We sought to identify trends in community and residential care before and after 1993 to facilitate this comparison.
Statistics were collated from diverse government publications and other authoritative sources.
Between 1985 and 1993 there was a progressive contraction of public community and residential services, as well as hospital beds available to the elderly. The concomitant huge increase in places publicly funded in private old people's and nursing homes appears to have been little affected by the implementation of the NHS and Community Care Act.
The NHS and Community Care Act has had little effect in curbing the institutionalization of old people, which has reached now the highest percentage this century at 7 per cent. A considerable expansion of community services would be required to return to the per capita provision of the early 1980s.
1990年的《国民健康服务与社区护理法案》于1993年4月1日开始实施，预计会深刻改变为老年人提供的居家服务。需要将这一变化与不采取任何行动时可能发生的情况进行比较。我们试图确定1993年前后社区和寄宿护理的趋势，以利于这种比较。
从各种政府出版物和其他权威来源收集统计数据。
1985年至1993年间，公共社区和寄宿服务以及可供老年人使用的医院病床数量逐渐减少。与此同时，私人养老院和疗养院中由公共资金资助的床位大幅增加，这似乎几乎未受《国民健康服务与社区护理法案》实施的影响。
《国民健康服务与社区护理法案》在抑制老年人机构化方面几乎没有效果，目前老年人机构化比例已达到本世纪最高的7%。若要恢复到20世纪80年代初的人均服务水平，需要大幅扩展社区服务。
