Workforce and Health Services, Griffith Health, Griffith University, Gold Coast, QLD, Australia ; Oxford PRAXIS Forum, Green Templeton College, Oxford University, Oxford, United Kingdom.
Allied Health Research, Mater Research Institute - The University of Queensland and Mater Mothers' Hospital, South Brisbane, QLD, Australia ; Griffith Health Institute, Griffith Health, Griffith University, Gold Coast, QLD, Australia.
J Multidiscip Healthc. 2014 Nov 24;7:543-9. doi: 10.2147/JMDH.S72636. eCollection 2014.
Globally, nations are confronted with the challenge of providing affordable health services to populations with increasing levels of noncommunicable and chronic disease. Paradoxically, many nations can both celebrate increases in life expectancy and bemoan parallel increases in chronic disease prevalence. Simply put, despite living longer, not all of that time is spent in good health. Combined with factors such as rising levels of obesity and related noncommunicable disease, the demand for health services is requiring nations to consider new models of affordable health care. Given the level of disease burden, all staff, not just doctors, need to be part of the solution and encouraged to innovate and deliver better and more affordable health care, particularly preventative primary health care services. This paper draws attention to a range of exemplars to encourage and stimulate readers to think beyond traditional models of primary health service delivery. Examples include nurse-led, allied health-led, and student-led clinics; student-assisted services; and community empowerment models. These are reported for the interest of policy makers and health service managers involved in preventative and primary health service redesign initiatives.
全球各国都面临着一个挑战，那就是要为那些患有不断增加的非传染性和慢性疾病的人群提供负担得起的医疗服务。具有讽刺意味的是，许多国家在庆祝预期寿命增加的同时，却又哀叹慢性疾病的发病率也在平行上升。简单地说，尽管人们的寿命延长了，但并非所有的时间都处于健康状态。再加上肥胖症和相关非传染性疾病发病率不断上升等因素，对医疗服务的需求迫使各国考虑新的负担得起的医疗保健模式。鉴于疾病负担的程度，所有工作人员，而不仅仅是医生，都需要成为解决方案的一部分，并鼓励他们创新，提供更好、更负担得起的医疗保健，特别是预防性初级卫生保健服务。本文提请注意一系列范例，以鼓励和激发读者超越初级卫生服务提供的传统模式进行思考。这些范例包括护士主导、联合健康主导和学生主导的诊所；学生协助服务；以及社区赋权模式。这些例子是为了让参与预防性和初级卫生服务重新设计计划的政策制定者和卫生服务管理者感兴趣。
