Redaelli Marcus, Meuser Susanne, Stock Stephanie
Institute of General Practice and Family Medicine, University Witten/Herdecke, Alfred-Herrhausen-Straße, Witten, Germany.
J Ambul Care Manage. 2012 Jul-Sep;35(3):182-91. doi: 10.1097/JAC.0b013e31823f0114.
Traditionally, Germany has a weak primary care system. In addition, the number of general practitioners (GPs) has declined in the past years. Main challenges are an aging population, disintegration of care, variations in care, an increase in chronic conditions, and a shortage of GPs especially in rural areas. Policy reacted by implementing financial incentives for GPs in rural areas and special GP training programs. Improvements in chronic care aim to better integrate care through Disease Management Programs, the electronic health card, and voluntary primary care schemes. The largest challenge to be addressed is the delegation of physician tasks to physician assistants.
传统上，德国的基层医疗体系较为薄弱。此外，全科医生的数量在过去几年有所下降。主要挑战包括人口老龄化、医疗服务碎片化、医疗差异、慢性病增加以及全科医生短缺，尤其是在农村地区。政策方面采取了对农村地区全科医生实施财政激励措施以及开展特殊的全科医生培训项目。慢性病护理方面的改进旨在通过疾病管理项目、电子健康卡和自愿基层医疗计划更好地整合医疗服务。需要应对的最大挑战是将医生任务委托给医生助理。
