Benjamin A E
School of Social Welfare, University of California, Los Angeles 90024-1452.
Milbank Q. 1993;71(1):129-66.
Although home care has received increased policy attention in recent years, the health services literature does not offer a historical perspective. The way home care is viewed and the nature of its support have changed significantly, yet history also suggests continuity. The era of modern medicine has relegated the status of home care to that of a residual set of follow-up services and there has been a lack of consensus about the goals of home care. For about 75 years, the legitimacy of home care has depended upon claims that it would relieve utilization and costs of institutional care, which has served both to maintain its policy salience and to undermine its legitimacy. Profound demographic and fiscal changes have increased the demand for home care, especially among the chronically ill, but various issues remain unresolved.
尽管近年来家庭护理受到了越来越多的政策关注，但卫生服务文献并未提供历史视角。人们对家庭护理的看法及其支持性质发生了显著变化，但历史也表明存在连续性。现代医学时代已将家庭护理的地位降为一系列残余的后续服务，而且对于家庭护理的目标一直缺乏共识。在大约75年的时间里，家庭护理的合法性取决于它能缓解机构护理的利用率和成本这一说法，这既维持了其在政策上的突出地位，也损害了其合法性。深刻的人口结构和财政变化增加了对家庭护理的需求，尤其是慢性病患者对家庭护理的需求，但各种问题仍未得到解决。
