CONTINUING HEALTH-CARE CRITERIA - THEIR USE IN A SPECIALIST DISABILITY SERVICE

Objective: to evaluate the British National Health Service (NHS) crite ria for determining eligibility for continuing health care when applie d to a population of younger people with severe, usually neurological disability. Design: an observational study with descriptive analysis o f the data. Setting: the specialist disability service catering to the population of Oxfordshire (560,000). Subjects: 196 patients in contac t with the specialist services in January 1996. Intervention: senior s taff graded the extent to which each patient had one or more of five h ealth and three non-health needs addressed by the service (rated on a scale of 0-3 for each item). Measures: the Oxfordshire Health Authorit y guidelines for determining eligibility were used, with an additional three criteria covering non-health needs (social interaction, support ing carers, supporting Social Service care packages).Results: 196 pati ents were assessed: 128 (65%) had all health and non-health needs bein g 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 s eparation either between different categories of health need or betwee n health and nonhealth needs. Conclusion: the current categories canno t be applied at the level of individual patients without conflict beca use: they are unclear, not being based on any logical, coherent framew ork in almost all patients the needs being met by health services incl ude many non-health needs.