国际全科医生制度发展历程:影响因素分析及政策启示

 
投稿时间: 2015-01-06  最后修改时间: 2015-01-27  摘要点击次数: 2830  全文下载次数: 4
 
引用本文:代涛, 黄菊, 马晓静.国际全科医生制度发展历程:影响因素分析及政策启示[J].中国卫生政策研究,2015,8(2):1-7
代涛, 黄菊, 马晓静
中国医学科学院医学信息研究所/卫生政策与管理研究中心 北京 100020
基金项目:国家卫生计生委委托项目
 
 摘要:全科医生制度建设的国际经验可以为中国全科医生制度的建立和发展提供借鉴。本文首先梳理了国民健康服务体制、社会医疗保险体制、商业医疗保险体制等部分典型国家的全科医生制度发展历程,重点分析了全科医生制度建设的影响因素。结果发现,建立和发展全科医生制度的主要影响因素有:经济社会因素、卫生保健体制对卫生体系的控制力、医师对卫生体系的控制力、全科医学服务的激励机制、全科医学的发展程度等。最后,结合近年我国全科医生制度建设的实际提出几点政策启示,一要以满足我国公众健康需求为目标,构建中国特色全科医生制度;二要普及全科医学服务核心价值,为建立全科医生制度提供公众民意基础;三要建立健全促进全科医生制度发展的激励机制,提高全科医生地位;四要积极推动全科与专科医学的专业分工,促进全科医学发展。 
  关键词:国际全科医生制度  发展历程  影响因素  政策启示
 
Development of international general practice system: Influencing factors and policy implications
DAI Tao, HUANG Ju, MA Xiao-jing
Institute of Medical Information, Center for Health Policy and Management, Chinese Academy of Medical Sciences, Beijing 100020, China
 
 Abstract:International experiences can provide evidences for general practitioners (GPs) system building in China. The paper reviews the development of GP systems from several typical countries of different insurance systems, including national health care systems, commercial medical insurance systems, and social medical insurance systems, etc. The factors that influence GPs systems are analyzed. It is found that the control force of health security system on health system, the control force of specialists on health system, the incentive mechanism of general practice, and the development of general medicine influence the establishment of GPs systems. Finally, this paper provide several policy implications: First, in order to meet the needs of public health, a GPs system with Chinese characteristics should be established; Second, the core values of general medicine should be promoted to provide public support for the establishment of a GPs system; Third, a sound incentive mechanism should be established for the development of a GPs system to improve the status of general practitioners; Fourth, the division of general practitioners and specialists should be promoted to improve the development of general medicine. 
 keywords:International general practice system  Development process  Influencing factors  Policy implications