Kumar Pratyush, Kumar Raman
Department of Geriatrics, Patna Medical College Hospital, Patna, Bihar, India.
Academy of Family Physicians of India, New Delhi, India.
J Family Med Prim Care. 2018 Nov-Dec;7(6):1157-1162. doi: 10.4103/jfmpc.jfmpc_254_18.
Half the world's people currently live in rural and remote areas. About 70% of the world's 1.4 billion people who are extremely poor live in rural areas. The problem is that the majority of healthcare providers prefer to serve in urban areas. Only a comprehensive and systematic approach can address these inequities. India, the largest democratic republic in the world, possesses 2.4% of the world's land area and supports 16% of the world's population. According to census 2011, 68.84% of population resides in rural areas. Nearly 86% of all the medical visits in India are made by rural inhabitants with a majority still traveling more than 100 km to avail healthcare facility, of which 70%-80% is born out of pocket landing them in poverty. A country's approach must systematically and simultaneously address legal coverage and rights, health worker shortages, extension of healthcare protection, and quality of care. Only then can equitable access for all be fully achieved. Those living in rural areas have access to health protection and services that meet the criteria of availability, affordability, accessibility, acceptability, and quality. Family medicine as a broad specialty has its role from womb till tomb. Family medicine is defined as a specialty of medicine which is concerned with providing comprehensive care to individuals and families by integrating biomedical, behavioral, and social sciences. As an academic discipline, it includes comprehensive healthcare services, education, and research. A family doctor provides primary and continuing care to the entire family within the communities; addresses physical, psychological, and social problems; and coordinates comprehensive healthcare services with other specialists, as needed. The practitioners in family medicine can play an important role in providing healthcare services to the suffering humanity. The general practitioner's responsibility in Medicare includes management of emergencies, treatment of problems relating to various medical and surgical specialties, care of entire family in its environment, appropriate referrals, and follow-up. He or she is the first-level contact for the patients and his or her family. Family medicine is the ideal solution to growing rural healthcare challenges. This article is a formal position paper of the Academy of Family Physicians of India.
目前,全球一半人口居住在农村和偏远地区。世界上14亿极端贫困人口中,约70%生活在农村地区。问题在于,大多数医疗服务提供者更倾向于在城市地区工作。只有采取全面系统的方法才能解决这些不平等问题。印度是世界上最大的民主共和国,拥有世界2.4%的土地面积,承载着世界16%的人口。根据2011年人口普查,68.84%的人口居住在农村地区。在印度,近86%的医疗就诊是由农村居民进行的,其中大多数人仍需跋涉100多公里才能获得医疗设施,而70%-80%的费用需自掏腰包,这使他们陷入贫困。一个国家的方法必须系统且同时解决法律覆盖范围和权利、卫生工作者短缺、医疗保健保护范围的扩大以及医疗质量等问题。只有这样,才能完全实现全民公平就医。生活在农村地区的人们能够获得符合可及性、可负担性、可达性、可接受性和质量标准的健康保护和服务。家庭医学作为一门广泛的专业,其作用贯穿从 womb 到 tomb 的全过程。家庭医学被定义为一门医学专业,通过整合生物医学、行为科学和社会科学,为个人和家庭提供全面的护理。作为一门学科,它包括全面的医疗保健服务、教育和研究。家庭医生在社区内为整个家庭提供初级和持续护理;解决身体、心理和社会问题;并根据需要与其他专科医生协调全面的医疗保健服务。家庭医学从业者在为受苦的人类提供医疗服务方面可以发挥重要作用。全科医生在医疗保险中的职责包括管理急诊、治疗与各种内科和外科专科相关的问题、在家庭环境中照顾整个家庭、进行适当的转诊以及随访。他或她是患者及其家庭的第一级联系人。家庭医学是应对日益增长的农村医疗挑战的理想解决方案。本文是印度家庭医生学会的一份正式立场文件。 (注:原文中“from womb till tomb”直译为“从子宫到坟墓”,意译为“从生到死”;“womb”指子宫,在这里表述不太符合常规医学语境,推测可能是笔误,正常表达或许是“from cradle to grave”,但按照任务要求未做修改。)