Ann Intern Med. 1995 Mar 1;122(5):380-90.
This overview of rural health care today shows the role that internal medicine can and should play in delivering primary care to rural populations. The American College of Physicians recommends changes to improve access to and delivery of primary care in rural areas. There are six specific recommendations. 1. Implementing universal health care coverage through a system that makes primary care equally affordable to rural populations. 2. Increasing the supply of primary care providers in rural areas by lessening specialty and geographic differentials in physician income. 3. Increasing the supply of primary care providers in rural areas by changing medical education to emphasize training enough rural physicians. 4. Decreasing professional isolation in rural areas through accessible continuing medical education and through telecommunications technology. 5. Identifying tertiary care needs at the community level and using state and federal funds to assist rural hospitals where access to care would be threatened by hospital closure. 6. Using innovative delivery systems that emphasize coordination and cooperation among providers, institutions, and communities.
当下对农村医疗保健的概述表明了内科在为农村人口提供初级保健方面能够且应该发挥的作用。美国医师协会建议做出改变,以改善农村地区初级保健的可及性和提供情况。有六项具体建议。1. 通过一个使农村人口能够平等负担得起初级保健的系统来实施全民医保覆盖。2. 通过缩小医生收入方面的专科差异和地域差异,增加农村地区初级保健提供者的数量。3. 通过改变医学教育以强调培养足够数量的农村医生,增加农村地区初级保健提供者的数量。4. 通过可获取的继续医学教育以及电信技术,减少农村地区的职业孤立状况。5. 在社区层面确定三级医疗需求,并利用州和联邦资金协助那些因医院关闭而面临医疗服务可及性受到威胁的农村医院。6. 使用强调提供者、机构和社区之间协调与合作的创新型医疗服务提供系统。