Vienonen M A, Vohlonen I J
WHO Special Representative of the Director General in Russia, WHO Office, 28 Ostozhenka St., 119034 Moscow, Russian Federation.
Int J Integr Care. 2001;1:e38. doi: 10.5334/ijic.18.
The purpose of this paper is to look at what has happened in Russia during the last ten years in the health care sector from the point of view of integrated care. This country, when it still was the leading subject of the Soviet Union, hosted in 1978 the Alma Ata Conference on Primary Health Care, which in many countries gave a strong boost on the development of multidisciplinary, community based care in a gate-keeper position. In Soviet Russia, PHC became marginalised and identical to poor level of care in remote areas of the country where people had very little choice and did not want to use it. Has the situation changed, and is Russia in practice addressing the problems created by the lack of integration, vertical treatment structures and over specialisation? In addition to the data sources that are referred to in the text, this paper is based on "gray literature" available in project reports and governmental documents, and on the personal experiences of the authors, who have worked for long periods of time in the Russian Federation as international experts dealing with health sector reforms and health policy formulation.
本文旨在从综合医疗的角度审视俄罗斯在过去十年医疗保健领域所发生的情况。该国在作为苏联主要成员国时，于1978年主办了阿拉木图初级卫生保健会议，该会议在许多国家有力地推动了以守门人为定位的多学科社区医疗的发展。在苏联时期的俄罗斯，初级卫生保健被边缘化，等同于该国偏远地区低水平的医疗服务，当地民众选择极少且不愿使用。情况是否有所改变？俄罗斯在实际中是否在解决因缺乏整合、垂直治疗结构和过度专业化所产生的问题？除了文中提及的数据源，本文还基于项目报告和政府文件中的“灰色文献”，以及作者们的个人经历，他们作为处理卫生部门改革和卫生政策制定的国际专家，在俄罗斯联邦长期工作。
