将专科治疗整合进入家庭医疗团队  

Integrating Specialty Care into Primary Care Teams

作　　者：Matthew E. Bernard Eric W. Klavetter Jennifer L. Pecina Abd Moain Abu Dabrh 迟春花(译)[4,5] 李楠(译) 

机构地区：[1]Mayo Clinic家庭医学部,美国明尼苏达州罗切斯特市14624 [2]Mayo Clinic科研管理部,美国明尼苏达州罗切斯特市14624 [3]Mayo Clinic家庭医学部,美国佛罗里达州杰克逊维尔市32256 [4]北京大学医学部全科医学学系,100071 [5]北京大学第一医院健康管理中心,北京市100034 [6]惠每医疗,北京市100088

出　　处：《中国全科医学》2017年第10期1147-1151,共5页Chinese General Practice

基　　金：Mayo Clinic在华合资公司惠每医疗的大力支持

摘　　要：人口老龄化、参保患者数量增加、付费模式由为服务付费的传统模式向基于价值的模式转变等,均要求医疗服务模式的创新。为了以优质低价的治疗满足患者群的需求,须将专科治疗整合进入家庭医疗团队,以提高跨学科治疗的连续性并控制医疗费用,从而实现"改善医疗水平和患者体验、提升人群健康水平、降低医疗费用"的三大目标。将专科治疗整合进入家庭医疗团队的策略包括增加在基层执业点的治疗量、培养有专业特长的家庭医生、设立社区专科医生(ICS)。本文总结了梅奥诊所(Mayo Clinic)贯彻执行上述3个策略的经验和成果,认为ICS模式在医生收入以工资制为基础的体系内是可行的。Aging populations,increasing numbers of insured patients,and a changing reimbursement model based on value rather than traditional fee for service all necessitate innovation in models of health care delivery. In order to meet the needs of patients with high - quality and low - cost treatment,the medical specialists should be integrated into the primary care team to improve continuity across the spectrum of care and to control costs,and thus achieve the Triple Aim for Populations：improving patient care and experience,improving population health,and decreasing costs of health care. Strategies for integrating specialty care into primary care team include increasing care delivery at point of care,developing primary care with special interest, integrated community specialists （ICS）. The paper summarizes the experience and achievement of Mayo Clinic in implementing the above three strategies,and argues that the ICS model is viable for those systems where physician compensation is salary based.

关 键 词：家庭医学 社区专科医生 梅奥诊所 

分 类 号：R197[医药卫生—卫生事业管理]