Abstract: As the reform of public health services in the United States is underway，primary health care has played a key role in its reform in recent years.In December 2018，the American Academy of Family Physicians（AAFP） published Vision and Principles of a Quality Measurement Strategy for Primary Care（the Principles）．It involves six core principles，including distinction between quality measures and performance measures，definitions of quality measures and performance measures，characteristics of general practice and data source standardization.This has laid a solid theoretical foundation for a new US quality measurement standard for primary care in the future.By analyzing the limitations of the traditional pay-for-performance，the methodology of quality improvement，and the theory in general practice，this article interpreted the core ideas of the Principles and compared it with quality measurement systems in the UK，EU，and Australia，so as to point out its theoretical breakthroughs in the traditional pay-for-performance model.Based on this，this article also analyzed its impact on the current quality measurement system of general practice service in China，and proposed two suggestions on formulating core performance indicators and urging support from relevant associations for self-assessment and quality improvement of general practitioners in China.

Key words: Primary health care；Health care evaluation mechanisms；Quality assurance, health care；Quality improvement；Performance evaluation；Family practice；General practice；United States

摘要： 美国的公共卫生服务正处于改革阶段，发展基层保健已成为其近年改革的关键环节。2018年12月美国家庭医生学会（AAFP）发布了《基层保健质量评估策略的愿景和原则》（《原则》），包括区分质量评估与绩效评估、定义质量评估和绩效评估、强调全科医学学科特性、对信息数据系统进行规范等6项核心原则，从而为未来全新的美国基层保健质量评估标准的出台奠定了坚实的理论基础。本文结合传统绩效支付模型的局限性、质量改进方法学、全科医学学科理论等相关背景知识，对该《原则》的核心思想进行了深度解析，并将其与英国、欧盟、澳大利亚的质量评估体系进行横向对比，指出了其对传统绩效支付模型的理论突破。在此基础上，本文进一步剖析了《原则》对目前中国全科医疗服务质量评估体系的影响，提出了制订中国全科医疗服务核心绩效指标、相关学会及机构应对中国全科医生的自主质量改进提供支持两项建议。

关键词: 初级卫生保健；卫生保健评价机制；质量保证, 卫生保健；质量改进；绩效评估；家庭医学；全科医学；美国