Page 9 - 2022-01-中国全科医学

·2· http://www.chinagp.net E-mail:zgqkyx@chinagp.net.cn

战。相应的解决策略包括：加强全科医学倡导功能，建立广泛社区的协作网络，发展全科医学职业组织等。结论 中
国的全科医学事业发展处于上升期。人力数量上有飞速发展，政府政策的推动性强，在基本医疗可及性上有快速改善，
基层医疗卫生服务利用率明显增加。作为知识和劳动密集型行业，全科业内和社会期望较高，同时存在明显压力，人
力存在不稳定因素，全科医生的自我身份认同仍有提升空间。对全科医学的经济投入仍需明朗。当前，中国全科医学
处于前所未有的促进环境中，医学界和全科同仁务必抓住机会促进其更好地发展，“化挑战为机会”，为全民健康赢
得更好结果。
【关键词】 全科医学；全科医生；行业报告； 结果与过程评价，卫生保健；卫生政策；卫生人力；卫生费用
【中图分类号】 R 197 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2021.00.337
杨辉，韩建军，许岩丽，等 . 中国全科医学行业十年发展：机会和挑战并存［J］. 中国全科医学，2022，25（1）：
1-13，28. ［www.chinagp.net］
YANG H，HAN J J，XU Y L，et al. Ten-year development of general practice in China：opportunities and
challenges［J］. Chinese General Practice，2022，25（1）：1-13，28.

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Ten-year Development of General Practice in China：Opportunities and Challenges YANG Hui 1，2* ，HAN Jianjun ，
2
2
2
2
XU Yanli ，GAO Xiaohuan ，WANG Yang ，YANG Yunli ，CAO Xinyang 2
1.Monash University，Melbourne 3168，Australia
2.Publishing House of Journal of Chinese General Practice，Beijing 100053，China
*
Corresponding author：YANG Hui；E-mail：hui.yang@monash.edu
【Abstract】 Objective To review the strengths and limitations of the development of general practice in China during
the last decade（2010—2020） and to assess the opportunities and challenges for its future development. Methods Data were
collected from statistic reports，journal articles and official policies and guidelines regarding general practice development in
China from 2010—2020. Donabedian model was applied to examine and assess the quality of essential general practice services in
China. SWOT analysis was used to identify internal and external determinants of general practice development in China. Results
（1）Structural quality of general practice：the ten-year policies about general practice development were a continuation
of the past relevant policies in essence but with developments，with highlights on continuous construction of general practice
workforce and discipline，tiered diagnosis and treatment and regional medical consortium，but relevant fiscal and management
policies still need improvements. The number of general medical workers has increased rapidly，while the lion's share of them are
still allocated at tertiary hospitals. Full-time equivalent is suggested to be used to predict the staffing and assess the performance
of these workers. The number of community health centres showed a steady increase，but its growth rate was still slower than
that of hospital facilities. Relevant health economics data need to be further supplemented. （2）Process quality of general
practice：in 2020，there were 2.045 billion visits in community health centers（stations） and township health centers，that
is，1.5 visits per person per year on average. There was a significant development when found only 1 visit per person per year
for primary care in 2010. However，the frequency of visits for primary care was still lower than that of visiting hospital-based
outpatients（an average of 2.7 visits per person per year）. The COVID-19 pandemic had a significant impact on community
health services/general medical services，and the number of outpatient visits dropped by about 20%. The number of general
practice research articles reached a peak in 2018，mainly focusing on bi-directional referrals，tiered diagnosis and treatment，
general practitioners（GPs）/family doctors，general medicine，community health services，chronic disease management
（especially hypertension and diabetes），and analysis of factors associated with aspects involved in general medical services.
General practice research is expected to provide more support for developing innovative and critical thoughts，more practice-
based evidence for clinical services，and more assistance for service quality and patient outcomes improvement as the discipline
advances. （3）Results of implementing general medical services：there is no sufficient evidence on the influence of general
medical services on people's health. The experiences and views of people including healthy individuals and patients indicated
that those receiving general medical services or contracted family doctor services perceived positive experience and expressed
high satisfaction，but perceptions and views of general population in the community toward general medical services need to be
explored. GPs' own experience and opinions on general practice were quite different. Gender，age，professional title，urban and
rural areas，and geographical location may be associated with their experience and job satisfaction. There may be instability in the
general practice workforce，mainly due to personal income，workload and time pressure. （4）The major strengths of developing
general practice in China are as follows：strong policy-based promotion and government leadership；rapidly constructing and
developing GPs teams owing to the excellent resource allocating ability shown by the centralized system from central to all local
governments；significantly enhanced general practice education and training systems；increased core professionals as general