Hutchinson Allen, Becker Lorne A
Section of Public Health, School of Health and Related Research, University of Sheffield, Sheffield, England, UK.
Ann Fam Med. 2004 May 26;2 Suppl 2(Suppl 2):S41-4. doi: 10.1370/afm.195.
Family physicians provide person-centered, continuous, comprehensive care that is accessible and available at the time of need. Although this core philosophy is shared around the world, its translation into actual practice can vary greatly with time and from place to place as family physicians adapt to local constraints and conditions. Factors driving these local variations include entrenched habits and patterns of care, funding systems, patient expectations, public policy, and the availability and quality of other critical health system components. This diversity provides both an opportunity and a challenge for family medicine research. The potential for fruitful comparisons and contrasts arising from natural experiments may require investigators to use multiple research methods capable of evaluating complex interventions and comparisons. Family medicine has the capacity to be an excellent laboratory in which research in representative populations can offer the pragmatic answers needed by practicing physicians. The nature of the research questions and interventions require the involvement of clinicians in the formulation of research questions and evaluation of the applicability of research results. The variations in implementation of the family medicine philosophy can be a potential asset because of the research opportunities they provide.
家庭医生提供以患者为中心、持续、全面的医疗服务,在需要时可随时获得且易于获取。尽管这一核心理念在全球范围内得到认同,但其在实际应用中的表现会因时间和地域的不同而有很大差异,因为家庭医生需要适应当地的限制条件。推动这些地区差异的因素包括根深蒂固的医疗习惯和模式、资金系统、患者期望、公共政策以及其他关键卫生系统组成部分的可及性和质量。这种多样性给家庭医学研究带来了机遇和挑战。自然实验产生富有成效的比较和对照的潜力,可能要求研究者运用多种能够评估复杂干预措施和比较的研究方法。家庭医学有能力成为一个出色的实验室,在具有代表性的人群中开展研究可为执业医生提供所需的实用答案。研究问题和干预措施的性质要求临床医生参与研究问题的制定以及研究结果适用性的评估。家庭医学理念实施过程中的差异可能是一项潜在资产,因为它们提供了研究机会。