Carrier Emily, Gourevitch Marc N, Shah Nirav R
Department of Emergency Medicine, New York University School of Medicine, New York, NY, USA.
Med Care. 2009 Jul;47(7):714-22. doi: 10.1097/MLR.0b013e3181a469b0.
The concept of the medical home has existed since the 1960s, but has recently become a focus for discussion and innovation in the health care system. The most prominent definitions of the medical home are those presented by the Patient-Centered Primary Care Collaborative, the National Committee for Quality Assurance, and the Commonwealth Fund. These definitions share: adoption of health information technology and decision support systems, modification of clinical practice patterns, and ensuring continuity of care. Each of these components is a complex undertaking, and there is scant evidence to guide assessment of diverse strategies for achieving their integration into a medical home. Without a shared vocabulary and common definitions, policy-makers seeking to encourage the development of medical homes, providers seeking to improve patient care, and payers seeking to develop appropriate systems of reimbursement will face challenges in evaluating and disseminating the medical home model.
家庭医疗的概念自20世纪60年代就已存在，但最近已成为医疗保健系统中讨论和创新的焦点。家庭医疗最突出的定义是由以患者为中心的初级保健协作组织、国家质量保证委员会和联邦基金提出的。这些定义的共同之处在于：采用健康信息技术和决策支持系统、改变临床实践模式以及确保护理的连续性。这些组成部分中的每一个都是一项复杂的任务，而且几乎没有证据可用于指导评估将其整合到家庭医疗中的各种策略。如果没有共享的词汇和通用的定义，寻求鼓励家庭医疗发展的政策制定者、寻求改善患者护理的提供者以及寻求制定适当报销系统的支付方在评估和推广家庭医疗模式时将面临挑战。
