多重疾病的 (失败的) 承诺:慢性,生物医学类别和公共卫生
Rebecca Lynch1, Benjamin Hanckel2, Judith Green3
1Department of Women & Children's Health, King's College London, London, UK.
多病症倡议旨在实现整体公共卫生,但会造成系统复杂性. 患者自我管理被强调在关系健康模型上,限制了真正的人口健康收益.
科学领域:
- 公共卫生 公共卫生
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 综合性疾病是老龄化人口的关键重点,以实现整体公共卫生.
- 现有的卫生系统在与碎片化和复杂性作斗争.
- 以前解决碎片化的尝试往往增加了复杂性.
研究的目的:
- 探索使用多病症作为公共卫生镜头的重点和局限性.
- 了解多病症如何在当地卫生倡议中得到动员.
- 检查政策叙述与患者经验之间的差距.
主要方法:
- 英国伦敦南部的情况分析.
- 对相关政策和倡议进行文献分析.
- 采访服务提供商,政策参与者和多种疾病的个人.
主要成果:
- 当地举措使用多病症来整合护理和委托预防,但增加了系统复杂性.
- 服务提供商和患者继续面临导航挑战.
- 政策强调个人自我管理,与患者的关系健康需求形成鲜明对比.
- 生物医学和流行病学方法限制了对人口健康和社会物质背景的关注.
结论:
- 多病症的概念为以人口为中心的公共卫生提供了潜力,但面临着局限性.
- 生物医学鼻科和流行病学方法之间的紧张关系阻碍了整体的观点.
- 解决多病症需要超越个体风险因素,转向关系因素和情境因素.
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