International Research Centre for the Advancement of Health Communication, Department of English and Communication, The Hong Kong Polytechnic University, Hong Kong, China.
BMC Prim Care. 2024 Sep 28;25(1):346. doi: 10.1186/s12875-024-02585-0.
The Asia Pacific Region's middle-income countries (MICs) face unique challenges in the ongoing development of primary care (PC) systems. This development is complicated by systemic factors, including rapid policy changes and the introduction of private healthcare services, as well as the mounting challenges associated with ageing populations and increasing rates of chronic diseases. Despite the widespread acknowledgement of the importance of family doctors in the development of PC services, relatively little is known about how these roles have developed in Asian MICs. To address this gap, this systematic review presents a synthesis of recent research focused on the role of family doctors within the PC systems of MICs in the Asia Pacific Region.
We searched six electronic databases (CINAHL Complete, Embase, PsycINFO, PubMed, Web of Science, and Index Medicus for the South-East Asia Region and Western Pacific) for peer-reviewed qualitative literature published between January 2010 and December 2020. The quality of the studies was evaluated using the Critical Appraisal Skills Programme tool. Eighteen articles were included in the analysis. Findings from these articles were extracted and synthesised using qualitative thematic synthesis. We used the Rainbow Framework to analyse the interconnections within health systems at the macro, meso and micro levels.
Our analysis of the included articles showed that family doctors play a crucial role in bridging the gap between hospitals and communities. They are essential in adopting holistic approaches to health and wellbeing and are in a unique position to try and address social, psychological, and biological aspects of health. Our findings also highlight the influence of policy changes at the macro level on the role and responsibilities of family doctors at the meso (organisational) and micro (interpersonal) levels.
Limited research has explored the role of family doctors in the ongoing development of primary care systems in MICs in the Asia Pacific Region. The findings of this review have significant implications for policymakers and healthcare administrators involved in ongoing improvements to and strengthening of PC systems. Areas of particular concern relate to policy linked with training and workforce development, insurance systems and public awareness of what primary care services are.
亚太地区中等收入国家（MICs）在基层医疗（PC）系统的持续发展中面临独特的挑战。这种发展受到系统因素的复杂化，包括快速的政策变化和引入私立医疗保健服务，以及与人口老龄化和慢性疾病发病率增加相关的日益严峻的挑战。尽管普遍认识到家庭医生在 PC 服务发展中的重要性，但对于这些角色在亚洲 MICs 中的发展情况，人们知之甚少。为了弥补这一空白，本系统综述综合了最近的研究，重点关注亚太地区 MICs 的 PC 系统中家庭医生的角色。
我们在六个电子数据库（CINAHL Complete、Embase、PsycINFO、PubMed、Web of Science 和 Index Medicus for the South-East Asia Region and Western Pacific）中搜索了 2010 年 1 月至 2020 年 12 月期间发表的同行评审定性文献。使用批判性评估技能计划工具评估研究的质量。有 18 篇文章被纳入分析。从这些文章中提取并综合了研究结果，使用定性主题综合法进行分析。我们使用彩虹框架分析宏观、中观和微观层面卫生系统内的相互关系。
我们对纳入文章的分析表明，家庭医生在弥合医院和社区之间的差距方面发挥着至关重要的作用。他们在采用整体健康和幸福感方法方面至关重要，并且处于独特的位置，可以尝试解决健康的社会、心理和生物方面的问题。我们的研究结果还强调了宏观层面政策变化对家庭医生在中观（组织）和微观（人际）层面的角色和责任的影响。
有限的研究探索了家庭医生在亚太地区 MICs 基层医疗系统持续发展中的作用。本综述的研究结果对参与 PC 系统持续改进和加强的政策制定者和医疗保健管理人员具有重要意义。特别关注的领域涉及与培训和劳动力发展、保险系统以及公众对初级保健服务的认识相关的政策。
