Reynolds P Preston, Klink Kathleen, Gilman Stuart, Green Larry A, Phillips Russell S, Shipman Scott, Keahey David, Rugen Kathryn, Davis Molly
University of Virginia, Charlottesville, VA, USA,
J Gen Intern Med. 2015 Jul;30(7):1013-7. doi: 10.1007/s11606-015-3229-2. Epub 2015 Feb 24.
As American medicine continues to undergo significant transformation, the patient-centered medical home (PCMH) is emerging as an interprofessional primary care model designed to deliver the right care for patients, by the right professional, at the right time, in the right setting, for the right cost. A review of local, state, regional and national initiatives to train professionals in delivering care within the PCMH model reveals some successes, but substantial challenges. Workforce policy recommendations designed to improve PCMH effectiveness and efficiency include 1) adoption of an expanded definition of primary care, 2) fundamental redesign of health professions education, 3) payment reform, 4) responsiveness to local needs assessments, and 5) systems improvement to emphasize quality, population health, and health disparities.
随着美国医学持续经历重大变革，以患者为中心的医疗之家（PCMH）正在成为一种跨专业的初级保健模式，旨在让合适的专业人员在合适的时间、合适的地点，以合适的成本为患者提供恰当的治疗。对地方、州、地区和国家层面为在PCMH模式下提供护理而培训专业人员的举措进行的一项审查发现了一些成功之处，但也存在重大挑战。旨在提高PCMH有效性和效率的劳动力政策建议包括：1）采用更广泛的初级保健定义；2）对卫生专业教育进行根本性重新设计；3）支付改革；4）响应地方需求评估；5）改进系统以强调质量、人群健康和健康差异。
