中国全科医学 ›› 2022, Vol. 25 ›› Issue (34): 4241-4251.DOI: 10.12114/j.issn.1007-9572.2022.0703

• 全科科研生产力研究报告 • 上一篇    下一篇

2001—2020年中国全科医学与社区卫生研究热点及趋势分析

金花1,2,3, 付强强1,2, 于德华1,2,3,*()   

  1. 1.200090 上海市,同济大学附属杨浦医院全科医学科
    2.200090 上海市全科医学与社区卫生发展研究中心
    3.200090 上海市,同济大学医学院全科医学系
  • 收稿日期:2022-08-30 修回日期:2022-09-22 出版日期:2022-12-05 发布日期:2022-09-29
  • 通讯作者: 于德华
  • 金花,付强强,于德华. 2001—2020年中国全科医学与社区卫生研究热点及趋势分析[J].中国全科医学,2022,25(34):4241-4251.[www.chinagp.net]
    作者贡献:
    于德华负责文章的构思和设计、质量控制及审校,对文章整体负责,监督管理;金花、付强强负责文献/资料的收集与整理;金花负责论文撰写与修订;付强强负责资料分析,参与论文修订。
  • 基金资助:
    国家自然科学基金资助项目(72104183); 上海市领军人才(YDH-20170627); 上海市医药卫生发展基金会课题(Se1202137); 第十批上海市杨浦区中心医院学科带头人"攀登计划"(Ye2202103)

Research Hotspots and Trends of General Practice and Community Health in China: Based on the Data of Chinese Journals in General Practice from 2001 to 2020

JIN Hua1,2,3, FU Qiangqiang1,2, YU Dehua1,2,3,*()   

  1. 1.Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
    2.Shanghai General Practice and Community Health Development Research Center, Shanghai 200090, China
    3.Academic Department of General Practice, School of Medicine, Tongji University, Shanghai 200090, China
  • Received:2022-08-30 Revised:2022-09-22 Published:2022-12-05 Online:2022-09-29
  • Contact: YU Dehua
  • About author:
    JIN H, FU Q Q, YU D H. Research hotspots and trends of general practice and community health in China: based on the data of Chinese journals in general practice from 2001 to 2020[J]. Chinese General Practice, 2022, 25 (34) : 4241-4251.

摘要: 背景 在日益增长的人民健康和医疗卫生改革需求下,全科医学及其服务模式被引入中国内地,并在国家政策支持与推进下快速发展。然而在全科医学的中国本土化过程中,其学科发展和服务模式尚不成熟,研究内容、实践路径与方法有待进一步明确。 目的 本研究通过对全科医学中文期刊刊发文献进行分析,梳理学科发展规律,发现理论研究与实践现状、发展需求间的差异,为我国全科医学学科发展提供参考依据。 方法 于2021年12月,在中国知网系统检索2001—2020年《中国全科医学》《中华全科医师杂志》《中华全科医学》《中国初级卫生保健》刊发的学术论文,提取关键词;同时检索国务院和国家卫生健康委的官方网站,以获取1997—2020年发布的全科医学与医药卫生体制改革相关政策文件。将2001—2020年按每5年划分为4个时间段,总结各阶段政策文件的主题。对2001—2020年及划分出的4个时间段的期刊文献关键词进行词频分析和共现分析,找出突现词,将其与各时间段的政策文件主题进行匹配分析。 结果 最终纳入文献54 726篇,提取出关键词1 398个,检索到相关政策文件62份。2001—2020年词频排在前10位的关键词分别为:"疗效"(2 998次)、"社区卫生服务"(2 235次)、"糖尿病"(2 004次)、"影响因素"(1 586次)、"老年人"(1 368次)、"诊断"(1 359次)、"高血压"(1 313次)、"全科医师"(1 303次)、"儿童"(1 302次)、"护理"(1 107次)。通过对2001—2020年期刊文献关键词进行聚类分析,可将全科医学与社区卫生领域的主要研究方向归纳为临床诊疗相关研究、疾病管理相关研究、社区卫生服务相关研究3大类。其中,临床诊疗相关研究涵盖疗效、护理、多种肿瘤疾病及多种实验室检查方法;疾病管理相关研究包含多种常见病和多发病,以慢性病研究为主,主要涉及糖尿病、高血压、慢性阻塞性肺疾病、冠心病、抑郁、妊娠期并发症、认知功能障碍等;社区卫生服务相关研究主要涉及健康教育、社区卫生、农村卫生、家庭医生签约服务等,还包括分级诊疗、双向转诊等社区卫生管理举措。突现词分析提示,2001—2005年的研究热点为疾病的临床分析/临床观察、社区卫生服务、乡镇卫生院、乡村医生等;2015年后,疾病的影响因素、分级诊疗、家庭医生签约服务、生存质量等成为研究热点,这与国家医疗卫生发展需求基本匹配。 结论 2001—2020年全科医学与社区卫生领域的研究体现了全科医学基本医疗和基本公共卫生的职能,具有覆盖全人群、全生命周期的特点,在关注躯体疾病的同时也关注心理健康,研究热点逐渐体现出"生物-社会-心理"的医学模式和"以人为中心"的特点,研究基本围绕国家医药卫生体制改革工作的需求开展。今后应进一步关注全科医学教育及医学模式创新,以期促进全科医学学科的持续发展。

关键词: 全科医学, 社区卫生服务, 科学研究, 卫生政策, 研究热点, 研究趋势, 文献计量学

Abstract:

Background

To meet the growing healthcare needs of people and requirements of the national healthcare reform, general practice and its service delivery models have been introduced into Chinese mainland, and developed rapidly with the support and promotion of national policies. However, the localization of general practice in China has revealed that the academic discipline development and delivery models of general practice are still immature, and the research content, practice path and research methods regarding general practice need to be further clarified.

Objective

To perform a review of the articles published in Chinese general practice journals to assess the academic discipline development, theoretic research and practice status, and focus areas for development regarding general practice, providing evidence for academic discipline development of general medicine in China.

Methods

In December 2021, the CNKI database was systematically searched for articles published in four representative Chinese general practice journals (Chinese General Practice, Chinese Journal of General Practitioners, Chinese Journal of General Practice, and Chinese Primary Health Care) from 2001 to 2020, and the official websites of the State Council and the National Health Commission of the People's Republic of China were searched for policy documents about general practice and the reform of the pharmaceutical and healthcare system issued from 1997 to 2020. The themes of policy documents in every five years in the period 2001—2020 were analyzed. And keywords of articles published in every five years in the period 2001—2020 were extracted for word frequency analysis and co-occurrence analysis, and for identification of the burst terms. Then the consistency of research hotspots with the themes of policy documents in every five years during 2001—2020 was assessed.

Results

Altogether, 54 726 articles were included, from which 1 398 keywords were extracted and sorted out, and 62 related policy documents were retrieved. The top 10 keywords in terms of frequency of use were "efficacy" (n=2 998) , "community health service" (n=2 235) , "diabetes" (n=2 004) , "influencing factors" (n=1 586) , "elderly people" (n=1 368) , "diagnosis" (n=1 359) , "hypertension" (n=1 313) , "general practitioner" (n=1 303) , "children" (n=1 302) and "nursing" (n=1 107) . By cluster analysis of key words, the major directions of research on general practice and community health during 2001—2020 were classified into three categories: clinical diagnosis and treatment (involving the efficacy assessment of treatment, nursing, and various laboratory examination methods, and diagnosis and treatment of multiple cancers) , disease management (including the management of various common diseases and frequently-occurring diseases, and most of them are chronic diseases, such as diabetes, hypertension, chronic obstructive pulmonary disease, coronary heart disease, depression, pregnancy complications, and cognitive dysfunction) , and community health services (mainly involving health education, community health, rural health, contracted family doctor services, tiered diagnosis and treatment, and bi-directional referral services) . The analysis of burst terms indicated that the focus of research during 2001—2005 was mainly on clinical analysis and clinical observation of diseases, community health services, township health centers, and rural doctors, and that during 2016—2020 was mainly on the analysis of influencing factors of diseases, tiered diagnosis and treatment, contracted family doctor services and quality of life, which were basically consistent with the requirements of the national policies regarding medical and health development.

Conclusion

The research regarding general practice and community health from 2001 to 2020 in China revealed that general medical services have played an important part in satisfying the needs of basic medical and public health, which cover all population throughout the entire lifecycle, and focus on addressing both somatic or mental health issues. Moreover, the related research hotspots were centered on the application of the biopsychosocial model and people-centered model, and basically targeting the requirements of the national reform of the pharmaceutical and healthcare system. It is recommended to paid more attention to general practice education and the innovation of medical models in future research, so as to promote the sustainable development of general practice.

Key words: General practice, Community health services, Research, Health policy, Research hotspots, Research trends, Bibliometrics