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of technology;based on the analysis of the common characteristics of primary care and integrated medical care,it illustrated
the booster role of primary care in integrating medical treatment at the above 5 levels. From the important role of general practice
departments in health care reform and meeting the needs of resident health services,Constructing General Medical Sciences as
National Key Clinical Specialty illustrated the need to create a general practice department as a state key clinical specialty,
and believed that creating a key clinical specialty need to do the following:creating a high-level of general practice department
status,advancing the construction and development of talents in general practice,enhancing the regional collaborative capacity
of general practice disciplines,and forming the characteristics of the full range of full cycle health care specialists,thereby
promoting the scientific research and innovation development of general practice medicine. Trends in the Development of Primary
Health in Shanghai affirmed the contributions of primary health to urban health development,and in the context of "big health",
further focused efforts were proposed to promote healthy aging and achieve birth population promotion;the development trend of
primary health in Shanghai lay in innovation,while innovation in high-quality development efforts of primary health required GPs
as both enablers and leaders to create new models of health services. Embrace Change,Become Better and Stronger argued that the
current "weakness" of community health services,was not the hardware or staffing deficit at the beginning of development,but
was embodied in the construction of general disciplines. Working staff in the field of general practice should take the initiative to
face and accept current changes from the national health strategy,in health needs,medical models,and their own development/
management,carry out active health,cope with the coexistence of multiple diseases,strengthen the general and special
combination,and focus on service evaluation from the perspective of consumers to assist the discipline construction of general
practice medicine.
【Key words】 General practice;Subject construction;Intergratvie medicine;Primary health care
由上海市医师协会、上海市医师协会全科医师分 因此,医疗服务模式的改革和创新是当前医疗改革的
会主办的“第二届海上全科医师论坛暨 2021—2022 关键,而医疗整合是医疗服务模式创新的重要尝试,
上海市医师协会全科医师分会年会”于 2022 年 7 月 以全科为重要组成部分的基层医疗可在其中发挥关
22 日在上海召开。论坛主题为:拥抱变化,更好更强! 键作用。
在论坛上,国内外全科领域知名专家就全科医学的 1 “整合”的概念与内涵
发展进展和研究热点进行报告,并围绕全科医学科 解释“整合”可以从整合程度、整合层次、整
的学科建设、基层卫生发展、社区临床质量提升等相 合方向 3 个维度来考虑。
关问题进行了广泛交流。本文旨在对论坛中的精彩 ◆整合程度:
内容进行报道,包括《基层医疗在整合医疗中的作用》 � (1)联系,即帮助患者联系提供医疗服务的第
《创建全科医学科为国家临床重点专科》《上海市 三方;
基层卫生发展趋势》《拥抱变化,更好更强》四部分。 � (2)协调,协调需要建立明确的结构,即在联
希望本文报道的内容可以推动全科医学学科建设, 系的基础上,确认第三方提供的服务是患者所需
助力基层医疗卫生事业发展。 要的;
� (3)全面整合,即建立新的项目或实体,给患
基层医疗在整合医疗中的作用 者提供需要的服务,这是真正意义上的整合。
石磊玉 美国霍普金斯大学彭博公共卫生学院医疗 ◆整合层面:
卫生政策与管理系教授 � (1)系统整合,即在区域范围内(如国家、省份)
制定战略规划,统筹融资和采购系统,确定服务
目前,几乎所有的国家都面临着来自医疗改革 项目和服务范围等;
的挑战,尽管各个国家的优先级不同,但控制不断 � (2)组织整合,即将组织内的社区卫生服务、
上涨的医疗费用和充分利用有限的医疗资源是各个 住院服务、康复服务等整合起来,是针对服务提
国家面对的共同问题 [1] 。越来越多的国家意识到, 供者的协调和管理;
由于医疗需求和医疗费用的不断上涨,目前的医疗 � (3)临床整合,涉及医护人员为患者提供的直
体制是非可持续的。近期发生的新型冠状病毒肺炎 接医护服务和支持。
(COVID-19)疫情,也进一步显现了当前医疗体系无 ◆整合方向:
法应对突发事件及其所带来的大规模需求的缺陷 [2] 。 � (1)纵向整合,即在同一组织内跨部门提供医