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在印度农村地区设立三级医疗机构:并非解决困扰卫生系统的所有弊病的唯一办法。

Setting up of tertiary care institutes in rural India: Not the sole remedy for all maladies plaguing the health system.

作者信息

Richa Richa, Kumar Vishal, Bhattacharya Sudip, Barik Sitanshu, Raj Vikash

机构信息

Department of Community and Family Medicine, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.

Department of Orthopaedics, PGIMER, Chandigarh, India.

出版信息

J Family Med Prim Care. 2025 May;14(5):2048-2052. doi: 10.4103/jfmpc.jfmpc_1565_24. Epub 2025 May 31.

Abstract

To achieve the goal of 'Health for All', the Indian government has introduced various schemes aimed at making affordable health care accessible to every citizen. However, rural, tribal, and remote areas face significant challenges due to poor infrastructure, unequal distribution of government resources, and a shortage of skilled healthcare workers. To tackle these issues, the government has focused on establishing premier tertiary care centres, including institutes of national importance like AIIMS, and upgrading existing tertiary facilities to offer specialty and super-specialty services under the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY). While these efforts are crucial, they represent only one part of building a strong and equitable healthcare system that serves all, regardless of social or economic status. Our case series emphasizes the importance of a holistic approach to health care. This includes reducing poverty, strengthening infrastructure, and improving health literacy through collaborative, multipronged efforts, particularly focusing on musculoskeletal diseases. Though these initiatives will take time to show results, they are essential for creating 'centres of excellence' that truly address the needs of the underserved, rather than isolated 'islands of excellence'.

摘要

为实现“全民健康”的目标,印度政府推出了各种计划,旨在让每个公民都能获得负担得起的医疗保健服务。然而,由于基础设施薄弱、政府资源分配不均以及缺乏熟练的医护人员,农村、部落和偏远地区面临着重大挑战。为解决这些问题,政府致力于建立一流的三级医疗中心,包括像全印医学科学研究所这样具有国家重要性的机构,并根据普拉丹·曼特里·斯瓦施亚·苏拉克沙·乔纳(PMSSY)计划升级现有三级设施,以提供专科和超专科服务。虽然这些努力至关重要,但它们只是建设一个强大且公平的医疗体系的一部分,该体系能为所有人服务,无论其社会或经济地位如何。我们的病例系列强调了全面医疗保健方法的重要性。这包括通过协作、多管齐下的努力减少贫困、加强基础设施建设以及提高健康素养,尤其关注肌肉骨骼疾病。尽管这些举措需要时间才能显现成效,但它们对于创建真正满足弱势群体需求的“卓越中心”至关重要,而不是孤立的“卓越孤岛”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8399/12178458/048f20d928cf/JFMPC-14-2048-g001.jpg

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