中国的初级卫生保健质量:挑战和建议
Xi Li1, Harlan M Krumholz2, Winnie Yip3
1National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.
Lancet (London, England)
|June 8, 2020
概括
在中国
科学领域:
- 公共卫生
- 卫生政策
- 医疗保健系统
背景情况:
- 中国对初级医疗保健的重大投资旨在管理高血压等慢性疾病和COVID-19等传染性疾病.
- 尽管增加了资金和政策,但中国的初级医疗保健质量仍然不理想.
- 现有的系统问题阻碍了有效的初级医疗保健服务.
研究的目的:
- 确定中国初级医疗保健质量低下的根本原因.
- 为改善初级医疗保健服务提供基于证据的政策建议.
- 探索中国初级医疗保健系统的现代化战略.
主要方法:
- 审查现有文献和政策分析.
- 确定中国初级医疗保健框架中的系统性挑战.
- 根据发现的缺口制定政策建议.
主要成果:
- 主要挑战包括医师培训不足,服务费模式偏好治疗而不是预防,护理分散,连续性不佳.
- 主要医疗保健从业人员的教育和培训不足.
- 服务费支付系统鼓励检测和治疗, 而不是预防.
结论:
- 加强培训,建立绩效问责制,整合临床和公共卫生服务,改善机构间协调至关重要.
- 建议通过数字数据和创新技术实现初级卫生保健系统的现代化.
- 解决系统性分散和鼓励预防性护理是提高质量的关键.
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