Wallace H K, Shorvon S D, Hopkins A
Research Unit, Royal College of Physicians, London, UK.
Seizure. 1997 Jun;6(3):185-91. doi: 10.1016/s1059-1311(97)80004-0.
A survey of all consultant neurologists was carried out to investigate the current provision of hospital-based adult epilepsy services in the UK and to compare the level of services offered by epilepsy and general neurology clinics. The valid response rate was 75%. Fifty-four epilepsy clinics were identified led by 43 neurologists in 46 hospitals. Over half the major neurological centres represented in the dataset had epilepsy clinics (31/58). Epilepsy clinics were significantly more likely than general neurology clinics to have on-site provision of a wide range of relevant investigations and associated specialists, and also shorter waiting times to see new patients with suspected seizures. There were also significant differences between epilepsy clinics and general neurology clinics in the provision of written information and counselling. Epilepsy clinics have definite advantages for patients over general neurology clinics in improving access to investigations and specialists and provision of psychosocial support, but the extent to which these translate into positive health outcomes needs further evaluation. A second survey of directors of public health concerning purchasing arrangements for epilepsy services confirmed that purchasers, as yet, are making little use of the contracting process to influence the quality of epilepsy services offered by providers of care.
我们对所有神经科顾问医生进行了一项调查，以研究英国目前基于医院的成人癫痫服务情况，并比较癫痫诊所和普通神经科诊所提供的服务水平。有效回复率为75%。我们确定了由46家医院的43名神经科医生领导的54家癫痫诊所。数据集中超过一半的主要神经中心设有癫痫诊所（31/58）。与普通神经科诊所相比，癫痫诊所更有可能在现场提供广泛的相关检查和相关专科医生，并且新疑似癫痫患者的候诊时间也更短。在提供书面信息和咨询方面，癫痫诊所和普通神经科诊所之间也存在显著差异。在改善检查和专科医生的可及性以及提供心理社会支持方面，癫痫诊所相对于普通神经科诊所对患者具有明显优势，但这些优势在多大程度上转化为积极的健康结果仍需进一步评估。第二项针对公共卫生主任的关于癫痫服务采购安排的调查证实，目前采购方很少利用合同流程来影响护理提供者提供的癫痫服务质量。
