McDermott R A
Tropical Public Health Unit, Queensland Health, Cairns.
Med J Aust. 2001 Jul 2;175(1):35-7. doi: 10.5694/j.1326-5377.2001.tb143510.x.
Implementing evidence-based medicine (EBM) in primary healthcare for Indigenous people will usually involve increasing services, particularly those for chronic conditions. As shown by the example of diabetes care, there are significant organisational, educational, economic, cultural and structural barriers to implementing EBM in many Indigenous communities. Many of these barriers could be reduced by better-organised service delivery systems at the community level, greater numbers of Indigenous health professionals and greater advocacy for healthy public policy by health services. There is evidence that delivering evidence-based primary healthcare, particularly for chronic diseases, can improve health outcomes in Indigenous communities. There is a need for more investment in strategies to implement EBM and evidence-based public health in Indigenous settings.
在基层医疗保健中为原住民实施循证医学(EBM)通常需要增加服务,尤其是针对慢性病的服务。正如糖尿病护理的例子所示,在许多原住民社区实施循证医学存在重大的组织、教育、经济、文化和结构障碍。通过在社区层面建立组织更完善的服务提供系统、增加原住民卫生专业人员数量以及卫生服务机构对健康公共政策的更多倡导,可以减少其中许多障碍。有证据表明,提供循证基层医疗保健,尤其是针对慢性病的保健,可以改善原住民社区的健康状况。需要对在原住民环境中实施循证医学和循证公共卫生的策略进行更多投资。