基层医疗卫生服务整合的国际经验及对我国的启示

目的:总结典型国家基层卫生服务提供中实现医防整合的经验,为我国基层医疗卫生服务整合提供借鉴。方法:本研究方法为文献研究。结果:在个人层面,英国、泰国、古巴培养全科医生作为"守门人"并将其作为提供医防整合服务的主体;在机构层面,各国基层机构组成服务网络,内部强调跨学科合作;在体系层面,通过横向合作和有序的首诊与转诊协调服务;国家立法保障和健康保险筹资等引导支持基层医疗卫生服务整合。结论:培养和配置高质量的医防一体的全科医生、促进机构跨学科融合、通过立法和筹资体系予以保障是各国提供基层整合型服务的核心,值得我国基层医防服务整合借鉴。

International experience for integration of primary healthcare and its enlightenment to China

Objective:To summarize the experience of achieving integration of clinical and preventive medicine in primary health care of typical countries, and to provide reference for China''s primary healthcare institutions.Methods:This paper was compiled by literature research method. Results:At different levels of concerns in the system, the results found that:First, from the individual level of service delivery, for example in the United Kingdom, Thailand, and Cuba, these institutions provide education and training for general practitioners(GPs) as the "gatekeepers", GPs provide clinical and preventive services together in the form of integrated health system. Second, from the perspective of institutional level, national primary health care institutions create service delivery networks and emphasize on interdisciplinary cooperation. Last but not least is the system level where, through horizontal and orderly first-contact and referral coordination services were found to be of great importance in the support of integrated health care in primary level medical institutions through the national legislation, health insurance financing, and so forth. Conclusion:The cultivation and deployment of high-quality general practitioners, the promotion of interdisciplinary integration within and beyond the organizations, and the guarantee through legislation and financing systems are the core of providing integrated primary health care in various countries. This paper was considered to be reference for primary integrated clinical and preventive services in China.