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澳大利亚新的初级卫生保健网络:它们将如何整合公共卫生与初级保健?

The new Australian Primary Health Networks: how will they integrate public health and primary care?

作者信息

Booth Mark, Hill Graham, Moore Michael J, Dalla Danielle, Moore Michael G, Messenger Anne

机构信息

Health Systems Policy Division, Strategic Policy and Innovation Group, Australian Government Department of Health, Canberra, ACT, Australia.

Public Health Association of Australia, Canberra, ACT, Australia.

出版信息

Public Health Res Pract. 2016 Jan 28;26(1):e2611603. doi: 10.17061/phrp2611603.

DOI:10.17061/phrp2611603
PMID:26863166
Abstract

On 1 July 2015, the Australian Government established 31 new Primary Health Networks (PHNs), following a review by its former Chief Medical Officer, John Horvath, of 61 Medicare Locals created under the previous Labor administration. The Horvath review recommended, among other things, that new, larger primary health organisations be established to reduce fragmentation of care by integrating and coordinating health services, supporting the role of general practice, and leveraging and administering health program funding. The two main objectives of the new PHNs, as stated on the Department of Health's website, are "increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time". Below are three viewpoints, commissioned for this primary health care themed issue of Public Health Research & Practice, from the Australian Government Department of Health, the Public Health Association of Australia and a Sydney-based PHN. We asked the authors to focus particularly on how the newly established networks might help to integrate public health within the primary health care landscape. Our authors have pointed out the huge overlap between public health and primary care and looked at evidence showing the great benefits for health systems of collaboration between the two. Challenges ahead include a possible government focus on delivery of 'frontline' medical services, which may come at the expense of population health, and the complexity of dealing with all primary health care stakeholders, including health professionals, Local Health Districts, nongovernment organisations, research institutions and local communities.

摘要

2015年7月1日,澳大利亚政府在前任首席医疗官约翰·霍瓦特对前工党政府设立的61个医疗保险地方机构进行审查之后,成立了31个新的初级卫生保健网络(PHNs)。霍瓦特的审查提出了多项建议,其中包括建立新的、规模更大的初级卫生保健组织,以通过整合与协调卫生服务、支持全科医疗的作用以及利用和管理卫生项目资金来减少医疗服务的碎片化。正如卫生部网站所述,新的初级卫生保健网络的两个主要目标是“提高为患者,特别是那些健康状况可能不佳的患者提供医疗服务的效率和效果,并改善医疗协调,以确保患者在正确的时间、正确的地点获得正确的治疗”。以下是为本期以初级卫生保健为主题的《公共卫生研究与实践》特刊撰写的三种观点,分别来自澳大利亚政府卫生部、澳大利亚公共卫生协会以及悉尼的一个初级卫生保健网络。我们要求作者特别关注新成立的网络如何有助于在初级卫生保健领域整合公共卫生。我们的作者指出了公共卫生与初级保健之间的巨大重叠,并审视了表明两者合作对卫生系统有巨大益处的证据。未来面临的挑战包括政府可能专注于提供“一线”医疗服务,这可能以牺牲人群健康为代价,以及应对包括卫生专业人员、地方卫生区、非政府组织、研究机构和当地社区在内的所有初级卫生保健利益相关者的复杂性。

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