Yamamoto M
Soc Sci Med. 1983;17(19):1419-31. doi: 10.1016/0277-9536(83)90039-4.
In this paper, the substance of the Alma Ata Declaration on Primary Health Care is discussed. Minimum requirements and working goals of Primary Health Care are reviewed. The health status of the Japanese people, and the medical and health delivery systems in Japan are considered, with reference to the Alma Ata Declaration. While the Alma Ata Declaration sets forth the goal of health for all by the year 2000, there is doubt as to whether, even in the developed countries, we will reach this goal. Health indices have improved considerably, but problems of delivery of medical care and health care still remain. Major problems discussed here are the regional disparity in availability of medical manpower and facilities, and the consequent disparity in health indices; sky-rocketing medical costs; the changing needs of Japan's aging population; and socialized medical care, and the lack of integration of insurance schemes. The most significant problem in delivery of Primary Medical Care in Japan is the lack of integration of health and medical services. This is discussed at length. In addition, the importance of health education to community health planning in Primary Health Care is discussed.
本文讨论了《阿拉木图初级卫生保健宣言》的实质内容。回顾了初级卫生保健的最低要求和工作目标。参照《阿拉木图宣言》，对日本民众的健康状况以及日本的医疗卫生服务体系进行了考量。虽然《阿拉木图宣言》提出了到2000年实现全民健康的目标，但即使在发达国家，能否实现这一目标仍存在疑问。健康指标有了显著改善，但医疗保健服务提供方面的问题依然存在。这里讨论的主要问题包括医疗人力和设施可及性的地区差异以及由此导致的健康指标差异；医疗费用飙升；日本老龄化人口不断变化的需求；社会化医疗保健以及保险计划缺乏整合。日本初级医疗保健服务提供中最显著的问题是健康与医疗服务缺乏整合。对此进行了详细讨论。此外，还讨论了健康教育在初级卫生保健社区健康规划中的重要性。
