分级诊疗制度下我国亚专长全科医生的发展及国外启示
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摘要
亚专长全科医生(GPwSI)的发展有利于降低综合性医院医疗服务的花费,缩短患者就医等候时间,优化医疗资源配置,使得全科医生和专科医师之间的联络更加畅通,从而更加有利于分级诊疗制度的发展。本文阐述了在分级诊疗制度下我国GPwSI发展的前景,回顾了国外GPwSI发展过程中所面临的问题及其对我国的启示,并提出相应的策略建议,以期为我国GPwSI的发展提供参考。
The development of general practitioners with special interests(GPwSI)is conducive to reducing the cost of medical services in general hospitals,shortening the waiting time for patients,optimizing the allocation of medical resources,making the communication between GPwSI and specialists more smooth,and thus more conducive to the development of graded diagnosis and treatment system. In this paper,we discussed the prospects for the development of GPwSI in China under the hierarchical medical system.And then we reviewed the problems faced by the foreign GPwSI in the development and their enlightenment to China.In the end,we proposed some corresponding strategic advices to provide a reference for the development of GPwSI in China.
The development of general practitioners with special interests(GPwSI)is conducive to reducing the cost of medical services in general hospitals,shortening the waiting time for patients,optimizing the allocation of medical resources,making the communication between GPwSI and specialists more smooth,and thus more conducive to the development of graded diagnosis and treatment system. In this paper,we discussed the prospects for the development of GPwSI in China under the hierarchical medical system.And then we reviewed the problems faced by the foreign GPwSI in the development and their enlightenment to China.In the end,we proposed some corresponding strategic advices to provide a reference for the development of GPwSI in China.
引文
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[10]秦江梅,林春梅,张丽芳,等.基层卫生综合改革重点联系区县患者基层就诊满意度研究[J].中国全科医学,2018,21(1):36-40.DOI:10.3969/j.issn.1007-9572.2018.01.009.QIN J M,LIN C M,ZHANG L F,et al.Patient satisfaction with primary care in highly focused districts/counties during the comprehensive reform of primary care system in China[J].Chinese General Practice,2018,21(1):36-40.DOI:10.3969/j.issn.1007-9572.2018.01.009.
[11]刘红梅,杨纲.多点执业背景下医生集团发展战略研究[J].卫生经济研究,2017,34(9):8-11.LIU H M,YANG G.Research on the development strategy of doctors'group under the background of multi practice[J].Health Economics Research,2017,34(9):8-11.
[12]王颖,张禹.丁香诊所的全科医生发展之路[J].中国卫生人才,2018,20(4):30-32.DOI:10.3969/j.issn.1008-7370.2018.04.014.WANG Y,ZHANG Y.The development of GP in DXY clinic[J].China Health Human Resources,2018,20(4):30-32.DOI:10.3969/j.issn.1008-7370.2018.04.014.
[13]WILLIAMS S,RYAN D,PRICE D,et al.General practitioners with a special clinical interest:a model for improving respiratory disease management[J].BJGP,2002,52:838-843.
[14]WILKINSON D,DICK M B,ASKEW D A.General practitioners with special interests:risk of a good thing becoming bad?[J].MJA,2005,183(2):84-86.
[15]JIWA M,EE H C,BEILBY J J.Will promoting general practitioners with special interests threaten access to primary care?[J].MJA,2007,187(2):71-72.
[16]NOCON A,LEESE B.The role of UK general practitioners with special clinical interests:implications for policy and service delivery[J].Br J Gen Pract,2004,54(498):50-56.
[17]JONES R,BARTHOLOMEW J.General practitioners with special clinical interests:a cross-sectional survey[J].BJGP,2002,52:833-834.
[2]中华人民共和国国务院办公厅.国务院办公厅印发《关于改革完善全科医生培养与使用激励机制的意见》[J].中国实用乡村医生杂志,2018,25(3):1.DOI:10.3969/j.issn.1672-7185.2018.03.001.General Office of the State Council of the People's Republic of China.Suggestions on reforming and perfecting the incentive mechanism for training and using general practitioners[J].Chinese Practical Journal of Rural Doctor,2018,25(3):1. DOI:10.3969/j.issn.1672-7185.2018.03.001.
[3]刘颖,邱艳,任菁菁.英国亚专科全科医师培养简介[J].中华全科医师杂志,2016,15(11):893-895.DOI:10.3760/cma.j.issn.1671-7368.2016.11.020.LIU Y,QIU Y,REN J J.Training of general practitioners with special interest in UK[J].Chinese Journal of General Practitioners,2016,15(11):893-895.DOI:10.3760/cma.j.issn.1671-7368.2016.11.020.
[4]王永晨.全科医生专长化:我国全科医生继续教育的新理念[J].中华医学教育探索杂志,2018,17(5):433-437.DOI:10.3760/cma.j.issn.2095-1485.2018.05.001.WANG Y C.General practitioner specialization:new concept of general practitioner's continuing education in China[J].Chinese Journal of Medical Education Research,2018,17(5):433-437.DOI:10.3760/cma.j.issn.2095-1485.2018.05.001.
[5]Department of Health.The NHS plan:a plan for investment,a plan for reform[R].London:The Stationery Office,2000.
[6]POLLARD L,ROGERS S,SHRIBMAN J,et al.A study of role expansion:a new GP role in cardiology care[J].Bmc Health Services Research,2014,14(1):205.DOI:10.1186/1472-6963-14-205.
[7]Department of Health and Royal College of General Practitioners.Implementing a scheme for general practitioners with special interests[R].London:The Stationery Office,2002.
[8]原国家卫生计生委网站.国务院:推进分级诊疗制度建设指导意见[J].中国医疗保险,2015,8(10):72.DOI:10.3969/j.issn.1674-3830.2015.10.028.National Health and Family Planning Commission.State council:guiding opinions on promoting the construction of graded diagnosis and treatment system[J].China Health Insurance,2015,8(10):72.DOI:10.3969/j.issn.1674-3830.2015.10.028.
[9]新华社.中共中央国务院印发《“健康中国2030”规划纲要》[EB/OL].(2016-10-25)[2019-03-02].http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
[10]秦江梅,林春梅,张丽芳,等.基层卫生综合改革重点联系区县患者基层就诊满意度研究[J].中国全科医学,2018,21(1):36-40.DOI:10.3969/j.issn.1007-9572.2018.01.009.QIN J M,LIN C M,ZHANG L F,et al.Patient satisfaction with primary care in highly focused districts/counties during the comprehensive reform of primary care system in China[J].Chinese General Practice,2018,21(1):36-40.DOI:10.3969/j.issn.1007-9572.2018.01.009.
[11]刘红梅,杨纲.多点执业背景下医生集团发展战略研究[J].卫生经济研究,2017,34(9):8-11.LIU H M,YANG G.Research on the development strategy of doctors'group under the background of multi practice[J].Health Economics Research,2017,34(9):8-11.
[12]王颖,张禹.丁香诊所的全科医生发展之路[J].中国卫生人才,2018,20(4):30-32.DOI:10.3969/j.issn.1008-7370.2018.04.014.WANG Y,ZHANG Y.The development of GP in DXY clinic[J].China Health Human Resources,2018,20(4):30-32.DOI:10.3969/j.issn.1008-7370.2018.04.014.
[13]WILLIAMS S,RYAN D,PRICE D,et al.General practitioners with a special clinical interest:a model for improving respiratory disease management[J].BJGP,2002,52:838-843.
[14]WILKINSON D,DICK M B,ASKEW D A.General practitioners with special interests:risk of a good thing becoming bad?[J].MJA,2005,183(2):84-86.
[15]JIWA M,EE H C,BEILBY J J.Will promoting general practitioners with special interests threaten access to primary care?[J].MJA,2007,187(2):71-72.
[16]NOCON A,LEESE B.The role of UK general practitioners with special clinical interests:implications for policy and service delivery[J].Br J Gen Pract,2004,54(498):50-56.
[17]JONES R,BARTHOLOMEW J.General practitioners with special clinical interests:a cross-sectional survey[J].BJGP,2002,52:833-834.