国外全科医学定义演进逻辑、核心特征对中国全科医学发展的启示

doi:10.12114/j.issn.1007-9572.2026.0077

中国全科医学 ›› 2026, Vol. 29 ›› Issue (25): 3553-3562.DOI: 10.12114/j.issn.1007-9572.2026.0077

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国外全科医学定义演进逻辑、核心特征对中国全科医学发展的启示

杨信¹^,², 王宏³, 徐浩枫¹, 韩建军⁴, 梁万年⁵^,^*(), 胡丙杰¹^,³^,⁶^,^*()

1．510120　广东省广州市，广州医科大学附属第一医院全科医学科
2．999078　澳门特别行政区，黑沙环卫生中心
3．510260　广东省广州市，广州医科大学附属第二医院全科医学科
4．100007　北京市，海峡两岸医药卫生交流协会
5．518055　广东省深圳市，南方科技大学全科医学院
6．511436　广东省广州市，广州医科大学　广东省高校基于大数据利用的卫生健康治理哲学社会科学重点实验室

收稿日期:2026-04-22 修回日期:2026-07-02 出版日期:2026-09-05 发布日期:2026-08-11
通讯作者: 梁万年, 胡丙杰

【通信作者】　梁万年，医学博士，教授，博士生导师，清华大学万科公共卫生与健康学院讲席教授，南方科技大学全科医学院院长。国家疾病预防控制专家委员会主任委员、国家卫生健康委疫情应对处置工作专家组组长、新发突发与重大传染病防控国家科技重大专项副总师、世界卫生组织《国际卫生条例》突发事件委员会委员，中国医师协会副会长、中华预防医学会副会长、中国医师协会全科医师分会会长、公共安全科学技术学会公共卫生安全与健康专业委员会主任委员、中国康复医学会康复大数据工作委员会主任委员、中国全科医生学术共同体（CACGP）召集人、健康中国研究网络召集人。《中国全科医学》杂志主编，主要从事流行病学、全科医学、卫生政策与管理、卫生改革与卫生技术评估、社区卫生服务管理等领域的研究工作。

【通信作者】　胡丙杰，医学博士，教授，博士生导师，广州医科大学党委常委、副校长。中国医师协会全科医师分会副会长、海峡两岸医药卫生交流协会全科医学分会副会长、国家卫生健康委全科医学规划教材第四轮评审委员会副主任委员、国家卫生健康委能力建设与继续教育全科医学专业委员会委员兼科研与转化组组长、广东省全科医学教学指导委员会主任委员、广东省高校"基于大数据的卫生健康治理"重点实验室主任、广东省高校全科医学创新研究团队负责人、广州市医师协会副会长、广东省医师协会全科医师分会名誉主任委员。《中国全科医学》杂志编委，主要从事全科医学教育与科学研究、基层卫生、医药卫生体制改革等相关工作。

作者贡献：

胡丙杰提出选题方向，对文章负责；杨信、王宏、徐浩枫、胡丙杰负责资料收集与整理，并撰写论文初稿；韩建军、梁万年、胡丙杰负责文章的质量控制及审校；所有作者确认了论文终稿。

基金资助:
广东省普通高校全科医学创新研究团队项目(2025KCXTD035); 广东省教育厅继续教育质量提升工程项目(JXJYGC2021DY0231); 广东省教育厅研究生教育创新计划项目(2021JGXM090，2023JGXM_111); 广州医科大学科研能力提升计划医院管理专项(2025SRP047)

Enlightenment of the Evolution Logic and Core Features of General Practice Definitions Abroad for the Development of General Practice in China

YANG Xin¹^,², WANG Hong³, XU Haofeng¹, HAN Jianjun⁴, LIANG Wannian⁵^,^*(), HU Bingjie¹^,³^,⁶^,^*()

1. Department of General Practice, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, China
2. Hac Sa Wan (Areia Preta) Health Centre, Macao Special Administrative Region, Macao 999078, China
3. Department of General Practice, the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
4. Cross-Straits Medicine Exchange Association, Beijing 100007, China
5. College of General Practice, Southern University of Science and Technology, Shenzhen 518055, China
6. Philosophy and Social Sciences Key Laboratory of Guangdong Higher Education Institutes for Health Governance Based on Big Data Utilization, Guangzhou Medical University, Guangzhou 511436, China

Received:2026-04-22 Revised:2026-07-02 Published:2026-09-05 Online:2026-08-11
Contact: LIANG Wannian, HU Bingjie

摘要/Abstract

摘要： 全科医学定义演进是学科身份确立、核心价值凝聚与实践范式迭代的集中体现。本文采用文献计量、历史划代、关键转折点与典型案例比较法，系统梳理英国、美国、澳大利亚及世界家庭医生组织（WONCA）欧洲全科医学定义的形成背景、阶段特征与内涵演变，对比不同国家和地区的制度差异与定义取向，明确里程碑事件。研究发现，全科医学定义历经功能描述、学科界定、价值凝聚、生态拓展四阶段，以"全人-家庭-社区"社会学辐射视角、"生物-心理-社会-文化-环境-存在"多维整合框架、首诊与连续性、情境适配、社区导向、社会责任为核心特征。2023年WONCA欧洲新版定义首次纳入"同一健康、地球健康与可持续性"，标志着全科医学迈入个体、群体与生态健康协同发展新阶段。我国全科医学兼具政策驱动与本土实践特点，但仍存在核心内涵落实不足、服务模式适配性不强、学科与人才培养衔接不紧、生态与公平价值体现薄弱等问题。基于国外全科医学定义演进规律与核心特征，本文提炼国际经验对我国全科医学发展的启示，从学科内涵、教育体系、政策保障、实践创新四方面提出优化建议，为推动我国全科医学高质量发展提供理论参考。

关键词: 全科医学, 家庭医学, 定义演进, 核心特征

Abstract:

The evolution of general practice definitions epitomizes the establishment of disciplinary identity, condensation of core values, and iteration of practical paradigms. This paper adopts bibliometric analysis, historical periodization, critical juncture analysis, and typical case comparison methods to systematically sort out the formation background, stage characteristics, and connotation evolution of general practice definitions in the United Kingdom, the United States, Australia, and WONCA Europe. It compares institutional differences and definitional orientations across countries and regions and identifies key milestone events. The study finds that the definition of general practice has undergone four stages: functional description, disciplinary definition, value consolidation, and ecological expansion, with core features centered on a whole person-family-community sociological radiation perspective, a bio-psycho-social-cultural-environmental-existential multi-dimensional integration framework, first-contact and longitudinal care, contextual adaptation, community orientation, and social responsibility. The 2023 revised WONCA European definition formally incorporates "One Health, Planetary Health, and Sustainability", marking a new stage of synergistic development of individual, population, and ecosystem health. While China's general practice bears the characteristics of policy-driven and localized practice, it still faces challenges such as insufficient implementation of core connotations, poor adaptation of service models, weak alignment between disciplinary construction and talent training, and inadequate reflection of ecological and equity values. Based on the evolution rules and core features of general practice definitions abroad, this paper summarizes the enlightenment of international experience for the development of general practice in China and puts forward optimization suggestions from disciplinary connotation, education system, policy support, and practical innovation, so as to provide theoretical references for promoting the high-quality development of general practice in China.

Key words: General practice, Family practice, Definition evolution, Core features

杨信,王宏,徐浩枫,等. 国外全科医学定义演进逻辑、核心特征对中国全科医学发展的启示[J]. 中国全科医学, 2026, 29(25): 3553-3562. DOI: 10.12114/j.issn.1007-9572.2026.0077.
YANG Xin,WANG Hong,XU Haofeng, et al. Enlightenment of the Evolution Logic and Core Features of General Practice Definitions Abroad for the Development of General Practice in China[J]. Chinese General Practice, 2026, 29(25): 3553-3562. DOI: 10.12114/j.issn.1007-9572.2026.0077.

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国外全科医学定义演进逻辑、核心特征对中国全科医学发展的启示

Enlightenment of the Evolution Logic and Core Features of General Practice Definitions Abroad for the Development of General Practice in China

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