Leicester M C, Pollock A M
Public Health Medicine, Merton, Sutton and Wandsworth Health Authority, London.
Public Health. 1996 Mar;110(2):109-13. doi: 10.1016/s0033-3506(96)80056-4.
The objective of this study was to review the processes by which individuals' needs are being assessed and related to local eligibility criteria under the new arrangements for community care. An audit of the assessment process, definitions and measurement of need against Department of Health guidance was undertaken across the eight social services departments in South Thames (West) region. The results showed there is no standard approach to assessing needs: all social services have developed different assessment processes and different criteria for identifying needs. None use standardised measures of dependency such as the Barthel Index. Scales for measuring dependency have been developed locally so are not comparable between local authorities. Whilst local authorities have published eligibility criteria, in the main, these are purely descriptive accounts with considerable variation in practice in how local authorities are determining eligibility for services. In many authorities there remains ambiguity as to whether published eligibility criteria relate to eligibility for assessment or eligibility for services. Only one authority had attempted to quantify population needs and service provision in advance of setting its eligibility criteria. In conclusion, information collected on individuals cannot be aggregated for use in population-based planning, nor for monitoring purposes in any of the eight local authorities. National guidance is required on definitions of need and eligibility criteria. There is a need for a standardised core community data set, which embraces both health and social care.
本研究的目的是回顾在社区护理新安排下，个人需求是如何被评估以及与当地资格标准相关联的过程。针对南泰晤士（西部）地区的八个社会服务部门，依据卫生部指南对评估过程、需求的定义及衡量进行了一次审计。结果显示，在评估需求方面没有标准方法：所有社会服务部门都制定了不同的评估流程和确定需求的不同标准。没有一个部门使用诸如巴氏指数等标准化的依赖程度衡量方法。衡量依赖程度的量表是在当地制定的，因此不同地方当局之间不具有可比性。虽然地方当局已经公布了资格标准，但主要是纯粹的描述性说明，在地方当局如何确定服务资格的实际操作中存在很大差异。在许多当局中，公布的资格标准是与评估资格还是服务资格相关仍不明确。只有一个当局在设定其资格标准之前试图对人口需求和服务提供进行量化。总之，收集到的关于个人的信息无法汇总用于基于人群的规划，也无法用于八个地方当局中任何一个的监测目的。需要国家在需求定义和资格标准方面提供指导。需要一个标准化的核心社区数据集，涵盖健康和社会护理。
