Colleges of Public Health and Medicine, University of Kentucky, Lexington, USA.
Am J Public Health. 2012 Jun;102 Suppl 3(Suppl 3):S312-6. doi: 10.2105/AJPH.2012.300724.
Multiple promising but unsustainable attempts have been made to maintain programs integrating primary care and public health since the middle of the last century. During the 1960s, social justice movements expanded access to primary care and began to integrate primary care with public health concepts both to meet community needs for medical care and to begin to address the social determinants of health. Two decades later, the managed care movement offered opportunities for integration of primary care and public health as many employers and government payers attempted to control health costs and bring disease prevention strategies in line with payment mechanisms. Today, we again have the opportunity to align primary care with public health to improve the community's health.
自上世纪中叶以来,人们曾多次试图维持将初级保健和公共卫生相结合的项目,但都不可持续。20 世纪 60 年代,社会正义运动扩大了初级保健的覆盖面,并开始将初级保健与公共卫生概念相结合,既满足社区的医疗需求,也开始解决健康的社会决定因素。20 年后,管理式医疗保健运动为整合初级保健和公共卫生提供了机会,因为许多雇主和政府支付方都试图控制医疗成本,并使疾病预防策略与支付机制保持一致。如今,我们再次有机会将初级保健与公共卫生相结合,以改善社区的健康状况。