Page 21 - 2022-34-中国全科医学

·4242· http://www.chinagp.net E-mail:zgqkyx@chinagp.net.cn

*
Corresponding author：YU Dehua，Professor，Chief physician，Doctoral supervisor；E-mail：ydh1404@sina.com
【Abstract】 Background To meet the growing healthcare needs of people and requirements of the national healthcare
reform，general practice and its service delivery models have been introduced into Chinese mainland，and developed rapidly
with the support and promotion of national policies. However，the localization of general practice in China has revealed that the
academic discipline development and delivery models of general practice are still immature，and the research content，practice
path and research methods regarding general practice need to be further clarified. Objective To perform a review of the articles
published in Chinese general practice journals to assess the academic discipline development，theoretic research and practice
status，and focus areas for development regarding general practice，providing evidence for academic discipline development of
general medicine in China. Methods In December 2021，the CNKI database was systematically searched for articles published
in four representative Chinese general practice journals（Chinese General Practice，Chinese Journal of General Practitioners，
Chinese Journal of General Practice，and Chinese Primary Health Care） from 2001 to 2020，and the official websites of the
State Council and the National Health Commission of the People's Republic of China were searched for policy documents about
general practice and the reform of the pharmaceutical and healthcare system issued from 1997 to 2020. The themes of policy
documents in every five years in the period 2001—2020 were analyzed. And keywords of articles published in every five years
in the period 2001—2020 were extracted for word frequency analysis and co-occurrence analysis，and for identification of the
burst terms. Then the consistency of research hotspots with the themes of policy documents in every five years during 2001—2020
was assessed. Results Altogether，54 726 articles were included，from which 1 398 keywords were extracted and sorted out，
and 62 related policy documents were retrieved. The top 10 keywords in terms of frequency of use were "efficacy"（n=2 998），
"community health service"（n=2 235），"diabetes"（n=2 004），"influencing factors"（n=1 586），"elderly people"
（n=1 368），"diagnosis"（n=1 359），"hypertension"（n=1 313），"general practitioner"（n=1 303），"children"
（n=1 302） and "nursing"（n=1 107）. By cluster analysis of key words，the major directions of research on general practice
and community health during 2001—2020 were classified into three categories：clinical diagnosis and treatment（involving the
efficacy assessment of treatment，nursing，and various laboratory examination methods，and diagnosis and treatment of multiple
cancers），disease management（including the management of various common diseases and frequently-occurring diseases，
and most of them are chronic diseases，such as diabetes，hypertension，chronic obstructive pulmonary disease，coronary heart
disease，depression，pregnancy complications，and cognitive dysfunction），and community health services（mainly involving
health education，community health，rural health，contracted family doctor services，tiered diagnosis and treatment，and bi-
directional referral services）. The analysis of burst terms indicated that the focus of research during 2001—2005 was mainly on
clinical analysis and clinical observation of diseases，community health services，township health centers，and rural doctors，
and that during 2016—2020 was mainly on the analysis of influencing factors of diseases，tiered diagnosis and treatment，
contracted family doctor services and quality of life，which were basically consistent with the requirements of the national policies
regarding medical and health development. Conclusion The research regarding general practice and community health from
2001 to 2020 in China revealed that general medical services have played an important part in satisfying the needs of basic medical
and public health，which cover all population throughout the entire lifecycle，and focus on addressing both somatic or mental
health issues. Moreover，the related research hotspots were centered on the application of the biopsychosocial model and people-
centered model，and basically targeting the requirements of the national reform of the pharmaceutical and healthcare system. It is
recommended to paid more attention to general practice education and the innovation of medical models in future research，so as
to promote the sustainable development of general practice.
【Key words】 General practice；Community health services；Research；Health policy；Research hotspots；Research
trends；Bibliometrics

全科医学是集临床医学、预防医学、康复医学、 国内地，以利于我国建立完善的基层医疗卫生服务
人文医学于一体的综合性医学学科。全科医学服务作 体系，保障和改善居民健康，降低医疗卫生负担。
为基本医疗卫生服务体系的重要部分，强调“以人 随着医药卫生体制改革的推进，我国全科医学人才
为中心”和服务的可及性、持续性、综合性、协调性， 培养、服务模式建立得到多项政策支持，全科医学得
因此被认为是能够促进医疗资源合理利用、促进“全 到快速发展 ［1-2］ 。全科医学被引入中国内地 30 多年
民健康”的经济且有效的医学服务模式 ［1-2］ 。20 世 来，全科医生队伍从 2008 年的 1 万人发展到了 2021
纪 80 年代，在日益增长的人民健康需求和医药卫生 年的 43.5 万人 ［3］ ，我国逐步构建起分级诊疗制度，
体制改革要求下，全科医学及其服务模式被引入中 并建立起家庭医生签约服务模式 ［4］ 。然而，全科医