面向社区的初级保健. 医疗保健改革的基石 医疗保健改革的基石
1Community Health Services, Denver Health and Hospitals, CO 80204-4507.
JAMA
|May 19, 1993
概括
美国人希望对医疗保健系统进行彻底改革,超越昂贵的以医院为中心的医疗保健. 面向社区的初级保健提供了一个平衡的,社会相关的模式,以改善医疗服务.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 医疗保健管理的管理
背景情况:
- 目前的美国医疗保健系统因其高成本和过度强调急性医院护理而受到批评.
- 有公共和政治要求进行医疗保健改革,但目前的提案往往缺乏对服务组织的关注.
- 现有的模型无法充分平衡急性医疗干预与社区基础的初级和预防性服务.
研究的目的:
- 倡导医疗保健组织和服务提供向更平衡和社会相关的模式转变.
- 突出目前成本控制和以金融为重点的改革提案的局限性.
- 将面向社区的初级保健作为有效医疗改革的潜在范式.
主要方法:
- 对当前医疗保健系统缺陷的概念分析.
- 审查政策建议及其组织影响.
- 检查面向社区的初级保健的原则和潜力.
主要成果:
- 目前的医疗改革工作是分散的,未能解决系统性的组织问题.
- 需要采取平衡的方法,将医疗保健与医疗保健,公共卫生与个人服务相结合.
- 面向社区的初级保健提供了一个更合理,更负责任,更有社会意义的医疗保健系统的框架.
结论:
- 面向社区的初级保健模式是改革美国医疗保健系统的可行范式.
- 改革必须平衡治疗和预防护理,以及急性医院服务与社区基础的初级保健.
- 采用社会响应医学方法可以提高医疗保健的相关性和有效性.
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