Continuing health care criteria: their use in a specialist disability service.
OBJECTIVE
to evaluate the British National Health Service (NHS) criteria for determining eligibility for continuing health care when applied to a population of younger people with severe, usually neurological disability.


METHODS
an observational study with descriptive analysis of the data.


METHODS
the specialist disability service catering to the population of Oxfordshire (560,000).


METHODS
196 patients in contact with the specialist services in January 1996.


METHODS
senior staff graded the extent to which each patient had one or more of five health and three non-health needs addressed by the service (rated on a scale of 0-3 for each item).


METHODS
the Oxfordshire Health Authority guidelines for determining eligibility were used, with an additional three criteria covering non-health needs (social interaction, supporting carers, supporting Social Service care packages).


RESULTS
196 patients were assessed: 128 (65%) had all health and non-health needs being satisfied by the service; multiple needs were being met in 165 (84%). Only 18 (9%) had no health needs being met. There was no clear-cut separation either between different categories of health need or between health and non-health needs.


CONCLUSIONS
the current categories cannot be applied at the level of individual patients without conflict because: they are unclear, not being based on any logical, coherent framework in almost all patients the needs being met by health services include many non-health needs.
Wade
D T
DT
Rivermead Rehabilitation Centre, Oxford.
D006233:Persons with Disabilities; D004739:England; D006285:Health Planning; D006801:Humans; D008134:Long-Term Care; D010166:Palliative Care; D012047:Rehabilitation Centers / Q000458:organization & administration*; D012144:Respite Care; D012947:Social Work