中国全科医学 ›› 2025, Vol. 28 ›› Issue (10): 1249-1255.DOI: 10.12114/j.issn.1007-9572.2023.0424

所属专题: 社区卫生服务最新研究合辑

• 论著·全-专结合专题研究 • 上一篇    下一篇

社区全专结合门诊建设模式及优化策略

石建军1,2,3,4, 金花1,2,3,4, 陆媛1,2,3,4, 于德华1,2,3,4,*()   

  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研究中心
    4.200090 上海市,同济大学医学院全科医学系
  • 收稿日期:2023-10-02 修回日期:2024-01-24 出版日期:2025-04-05 发布日期:2025-01-23
  • 通讯作者: 于德华

  • 作者贡献:

    石建军负责研究过程的实施、最终版本的修订并对论文负责;金花、于德华提出研究思路,设计研究方案;陆媛、于德华负责论文审查。

Construction Model and Optimization Strategy of Outpatient Clinics of Combination of General Practice and Specialty in the Community

SHI Jianjun1,2,3,4, JIN Hua1,2,3,4, LU Yuan1,2,3,4, YU Dehua1,2,3,4,*()   

  1. 1. Department of General Practice, Yangpu Hospital of Tongji University, Shanghai 200090, China
    2. Shanghai General Practice and Community Health Development Research Center, Shanghai 200090, China
    3. Clinical Research Center for General Practice, Tongji University School of Medicine, Shanghai 200090, China
    4. Academic Department of General Practice, Tongji University School of Medicine, Shanghai 200090, China
  • Received:2023-10-02 Revised:2024-01-24 Published:2025-04-05 Online:2025-01-23
  • Contact: YU Dehua

摘要: 我国基层医疗卫生机构全科医生专业能力、基础设施相对薄弱,综合性医院专科医生时间、精力有限但医疗资源较充足,加强全科-专科医生合作,可以有效提升社区医疗质量、促进患者健康。本文系统梳理了国内外全专结合门诊建设的典型案例,从全专结合门诊概念的来源、内涵、建设模式、存在问题及优化策略等多个方面进行了阐述。综合全专结合门诊建设可能面临的挑战,并针对各地区不同的全专结合门诊实践方法,提出了5个方面的建议:完善全专结合门诊建设规章制度、协调统一全专结合门诊路径、注重全专结合门诊团队绩效激励、提升居民认可度、完善全专结合门诊诊疗评价标准。进一步拓展社区服务职能,深化与专科医师的合作是未来全专结合门诊建设探索的重要方向。政府、医疗机构和全、专科医师的共同参与、推动,才能更好地促进社区全专结合门诊的建设发展。

关键词: 全科医学, 全专结合, 诊疗模式,医师, 社区卫生服务, 建设模式, 优化策略

Abstract:

The professional capacity and infrastructure of general practitioners in grass-roots medical and health institutions in China are relatively weak, and the energy of specialists in general hospitals is limited and resources are abundant. Strengthening the cooperation between general practitioners and specialists can effectively improve the quality of community medical care and promote the health of patients. This paper systematically sorts out the typical practices and experiences of the construction of outpatient clinics of integration of general practice and specialty, and takes the source, connotation, construction path and construction path of the concept of full-specialty combination of outpatient clinics development effectiveness, existing problems and strategic recommendations are elaborated. Point out the challenges that may be faced in the construction of outpatient clinics of integration of general practice and specialty management model. In addition, this paper summarizes the possible challenges of the construction of integrated outpatient clinics, and puts forward five suggestions for the different practice methods of integrated outpatient clinics in different regions: improve the rules and regulations for the construction of outpatient clinics of integration of general practice and specialty, coordinate and unify the outpatient path of outpatient clinics of integration of general practice and specialty, pay attention to the protection of outpatient clinics of integration of general practice and specialty teams, clarify the population of outpatient clinics of integration of general practice and specialty services, and improve the health evaluation system for the outcomes of outpatient clinics of integration of general practice and specialty. In order to provide reference for the country to carry out the construction of outpatient clinics of integration of general practice and specialty in depth. Further expanding the community service function and deepening the cooperation with specialist physicians is an important direction for the future exploration of the construction of outpatient clinics of integration of general practice and specialized health care service. The joint participation and promotion of the government, medical institutions and general and specialist physicians can better promote the construction and development of community general and specialized outpatient clinics.

Key words: General practice, Integration of general practice and speciality, Practice patterns, physicians', Community health services, Construction model, Optimization strategy

中图分类号: