School of Medicine, Case Western Reserve University, Cleveland, OH 44107, USA.
Am J Public Health. 2012 Jun;102 Suppl 3(Suppl 3):S336-41. doi: 10.2105/AJPH.2011.300553.
We sought to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities.
We conducted 13 semistructured interviews in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard-defining organizations with influence over health care reform policies and implementation. We recorded the interviews and used an editing and immersion-crystallization analysis approach to identify themes.
We identified 4 themes: (1) affirmation of primary care as the foundation of a more effective health care system, (2) the patient-centered medical home as a transitional step to foster practice innovation and payment reform, (3) the urgent need for an increased focus on community and population health in primary care, and (4) the ongoing need for advocacy and research efforts to keep primary care on public and policy agendas.
Current efforts to reform primary care are only intermediate steps toward a system with a greater focus on community and population health. Transformed and policy-enabled primary care is an essential link between personalized care and population health.
我们试图了解在新出现的政治机遇背景下,国家政策主要知情者如何看待初级保健的价值和不断变化的作用。
我们于 2011 年 5 月对联邦机构、智库、非营利组织和对医疗改革政策制定和实施有影响力的质量标准制定组织的领导人进行了 13 次半结构化访谈。我们记录了访谈内容,并采用编辑和沉浸式结晶分析方法来确定主题。
我们确定了 4 个主题:(1)肯定初级保健是更有效医疗体系的基础;(2)以患者为中心的医疗之家是促进实践创新和支付改革的过渡步骤;(3)迫切需要更加关注初级保健中的社区和人群健康;(4)持续需要倡导和研究工作,以保持初级保健在公众和政策议程上的地位。
当前改革初级保健的努力只是向更加关注社区和人群健康的体系迈进的中间步骤。经过转型和政策支持的初级保健是个性化护理和人群健康之间的重要环节。