Starfield Barbara, Shi Leiyu, Macinko James
Johns Hopkins University, Baltimore, MD, USA.
Milbank Q. 2005;83(3):457-502. doi: 10.1111/j.1468-0009.2005.00409.x.
Evidence of the health-promoting influence of primary care has been accumulating ever since researchers have been able to distinguish primary care from other aspects of the health services delivery system. This evidence shows that primary care helps prevent illness and death, regardless of whether the care is characterized by supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care. The evidence also shows that primary care (in contrast to specialty care) is associated with a more equitable distribution of health in populations, a finding that holds in both cross-national and within-national studies. The means by which primary care improves health have been identified, thus suggesting ways to improve overall health and reduce differences in health across major population subgroups.
自从研究人员能够将初级保健与卫生服务提供系统的其他方面区分开来,有关初级保健促进健康影响的证据就一直在不断积累。这些证据表明,初级保健有助于预防疾病和死亡,无论这种保健的特点是有初级保健医生提供服务、与初级保健机构建立关系,还是接受初级保健的重要特征。证据还表明,初级保健(与专科保健相比)与人群中更公平的健康分布相关,这一发现在跨国研究和国内研究中都成立。已经确定了初级保健改善健康的方式,从而为改善整体健康状况和缩小主要人群亚组之间的健康差异提供了方法。