School of Medicine, Case Western Reserve University, Cleveland, Ohio 44107, USA.
Am J Prev Med. 2012 Jun;42(6 Suppl 2):S184-90. doi: 10.1016/j.amepre.2012.03.013.
The goal of the study was to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities.
Thirteen semistructured interviews were conducted in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard-defining organizations with influence over healthcare reform policies and implementation. Interviews were recorded; an editing and immersion-crystallization analysis approach was used to identify themes.
Four themes were identified: (1) affirmation of primary care as the foundation of a more effective healthcare 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.
本研究旨在了解国家政策主要知情者如何在新出现的政治机遇背景下,看待初级保健的价值和不断变化的作用。
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。访谈进行了录音,采用编辑和沉浸结晶分析方法来确定主题。
确定了四个主题:(1)肯定初级保健是更有效的医疗体系的基础;(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)需要持续进行宣传和研究工作,以保持初级保健在公众和政策议程上的地位。
目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。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联系。