Abstract: Background　During accelerating the implementation of family physician services，the efficiency of family physicians may be enhanced by the help from an allocated assistant，a role commonly referred to as family physician assistant. Community health centers in some regions of China，such as Shanghai and Beijing，have developed a healthcare delivery mode with family physicians as the core workforce and the main subject of liability，and nurses as major assistants. However，there is still a lack of uniform standard for the constituents of the core workforce of family physician teams，as well as the features，work scope and salary system of family physician assistants. Objective　To perform a sino-foreign comparative analysis of family physician assistants，providing a reference for the development of this occupational group in China. Methods　From November 5 to 20，2019，we searched the databases of PubMed，ScienceDirect，CNKI and WANFANG DATA for articles involving family physician assistants published between 2009 and 2019 using subject headings or key words such as "amily physician assistant" "general practitioner assistant" "全科医生助理" "家庭医生助理" or "家庭医生 and助理" or "全科医生and助理". Data about staffing allocation，features，major responsibilities and duties，performance assessment and performance-based remuneration allocation of family physician assistants were extracted and analyzed using bibliometric analysis，and were summarized. Results　By reviewing the full text，47（31 in English and 16 in Chinese） were found to be eligible. The role of family physician assistant mainly played by full-time physician assistant，nurse，public health physician，rural physician，and general practitioner assistant fostered by a "3+2" general practitioner training program. The difference is that，the position at abroad is held by those who have received pre-service physician assistant training，and obtained the practicing certification or academic credentials，but in China，the full-time position is held by mainly physician assistants of non-medical majors after receiving pre-service family physician assistant training，and the part-time positions，such as nurses，public health physician，and rural physician，are held by incumbent healthcare workers from the community health center. The responsibilities and duties of family physician assistants differ in different countries，but mainly include delivering therapies，health management，health education，triage，preliminary health assessment and chronic disease follow-up. The performance of the family physician assistant is commonly assessed by the healthcare institution using a uniform system，or assessed directly by the family physician at abroad，while in China，that is assessed by institutional uniform assessment，or a two-level assessment，namely，the quality of services included in the whole tasks of the community health center is assessed the quality-control department of the center using a uniform system，and the quality of family physician services is assessed the family physician. Conclusion　Great differences have been found between foreign countries and China in terms of occupational aptitudes，major responsibilities and duties，performance assessment and performance-based remuneration allocation of family physician assistants. In view of this，it is suggested to develop the family physician assistant team with general practitioners and nurses/rural physicians or general practitioners and full-time physician assistants as the core workforce，define the responsibilities and duties for family physician assistants multi-levelly，and formulate a remuneration allocation system based on three major indicators，complexity of medical techniques，and quality and quantity of services.

Key words: General practitioner assistant, Service mode, Literature review, Personnel allocation, Service content, Performance allocation

摘要： 背景　在加速推进家庭医生责任制服务进程中，为家庭医生配置类似助手的角色，可有效提升家庭医生的服务效率，该助手角色通常被称为家庭医生助理。上海、北京等社区卫生服务中心已经构建了以家庭医生为核心和责任主体的、护士作为主要助理人员的服务模式。但对于家庭医生团队的核心人员结构、家庭医生助理的人员特征、工作范围和薪酬体制等还缺少统一的标准。目的　了解国内外家庭医生助理的服务模式运行现况，为我国家庭医生助理的服务模式建设提供借鉴。方法　于2019年11月5—20日，选择PubMed、ScienceDirect、中国知网（CNKI）和万方数据知识服务平台为文献搜索引擎，在数据库中检索与家庭医生助理模式（包括家庭医生助理的人员配置及人员特征、主要职责及服务内容、绩效考核方式及分配方式等）相关的文献，检索时间范围为2009—2019年，检索词（主题词或关键词）为“family physician assistant”OR“general practitioner assistant”OR“全科医生助理”OR“家庭医生助理”OR“家庭医生”AND“助理”OR“全科医生”AND“助理”。通过评阅文献内容，总结国内外家庭医生助理模式开展现状。结果　阅读全文后最终获得符合要求的文献47篇，其中英文文献31篇，中文文献16篇。家庭医生助理主要由专职医生助理、护士、公共卫生医生、乡村医生、“3+2”助理全科医生担任；人员特征方面，国外的医生助理通常为接受过“医生助理”项目培训并取得相应资格或学历的专业人员；中国承担家庭医生助理的专职医生助理主要由非医学专业人员经过岗位培训后担任，担任家庭医生助理的护士、公共卫生医生和乡村医生都是由社区卫生服务中心在岗的卫生专业人员兼任。家庭医生助理的职责范围在不同国家有不同的规定，主要包括患者治疗方案的实施、健康管理、健康宣教、患者分诊、健康初步评估、慢性病随访等。在绩效考核方式方面，国外家庭医生助理一般由机构根据统一的考核指标体系进行考核，或由家庭医生直接对助理进行考核；中国家庭医生助理的绩效考核方式包括二级考核，机构质控部门统一考核，涉及全中心的工作内容由机构统一考核、与家庭医生工作相关内容由家庭医生考核。结论　国内外家庭医生助理在人员特征、主要职责和绩效考核分配方式上存在较大差异，建议构建以“全科医生+护士/乡村医生”或“全科医生+专职助理”为核心人员的家庭医生服务团队，分类设立家庭医生助理的岗位职责和服务内容，建立以“医疗技术的复杂程度”“服务质量”“工作数量”作为主要绩效考核指标的薪酬分配制度。

关键词: 家庭医生助理, 服务模式, 文献计量学, 人员配置, 服务内容, 绩效分配