Gay B
Université Bordeaux Segalen, 146, rue Léo-Saignat, 33076 Bordeaux, France.
Rev Epidemiol Sante Publique. 2013 Jun;61(3):193-8. doi: 10.1016/j.respe.2013.01.095. Epub 2013 Apr 29.
Primary healthcare is poorly structured in France while it is well defined at the international level: it is the point of first medical contact of the population with the healthcare system. General practice is the clinical specialty oriented to primary healthcare. Data in the scientific literature highlight the need of refocusing the health system on primary care known to improve both morbi-mortality and care efficiency. In France, health authorities acknowledge general practitioners as playing a key role in the health care system: its time to move from intention to action. Structural changes are needed to achieve this reinforcement of primary healthcare: to re-orientate medical studies towards primary care; to develop research in primary care; to promote cooperation between care providers; to ease the daily workload of practitioners; to diversify methods of payment; to propose a guide for patient's use of primary care. The transformation of the healthcare system in France requires a real strategy of primary healthcare implementation. Regardless of financial constraints, it is possible to redistribute the resources towards ambulatory care. Strengthening the role of general practice and favoring its societal recognition will be the major stages of this change.
法国的初级医疗保健体系结构不完善，而在国际层面其定义明确：它是民众与医疗保健系统的首次医疗接触点。全科医疗是面向初级医疗保健的临床专科。科学文献中的数据凸显了将卫生系统重新聚焦于初级保健的必要性，因为初级保健已知可改善疾病死亡率和医疗效率。在法国，卫生当局认可全科医生在医疗保健系统中发挥关键作用：是时候从意向转为行动了。需要进行结构变革以加强初级医疗保健：将医学研究重新导向初级保健；开展初级保健研究；促进医疗服务提供者之间的合作；减轻从业者的日常工作量；使支付方式多样化；为患者使用初级保健提供指导。法国医疗保健系统的转型需要一项切实可行的初级医疗保健实施战略。无论财政限制如何，都有可能将资源重新分配到门诊医疗。加强全科医疗的作用并促进其社会认可度将是这一变革的主要阶段。
