In this commentary, we elucidate two distinctive characteristics of China's primary health care system relative to the global primary health care framework: a more narrowly defined patient population and scope of services, along with a diminished clinical capacity in primary care. Building upon this foundation, we critically examine and juxtapose the two quintessential theoretical-practical models of the 20th century that are intimately linked with the integration of medication and prevention. They are the "Community-Oriented Primary Care" Model and the "Barefoot Doctor" Model. Additionally, leveraging a series of practical cases observed within Shanghai's primary care settings in the fourth quarter of 2023, we deliberate on viable approaches for adapting and applying these models in China's primary care infrastructure. We further delineate the requisite external conditions for such a transformation and offer targeted recommendations for the deployment of these models across diverse locales.

本篇评论阐明了我国基层医疗卫生体系相对于国际初级卫生保健体系的两个独特特点：更狭窄的患者人群和业务范围，以及更薄弱的基本医疗能力。以此为基础，文章总结和对比了20世纪的两种最具代表性的，且在全球产生了广泛影响的两种与医防融合关系极为密切的整合基本医疗服务中的临床和公共卫生部分的理论-实践模式："社区导向的基本医疗"模式和"赤脚医生"模式。在此基础上，本文进一步结合于2023年第四季度在上海市基层医疗卫生体系中观察到的多项实际案例，阐述了未来在我国的基层医疗卫生机构中，转化和实施这两种医防融合模式的可行路径和对外部条件的需求，并提出了在不同地区实施上述模式的原则性建议。