Franks P, Nutting P A, Clancy C M
Division of Primary Care, Agency for Health Care Policy and Research, Rockville, MD.
JAMA. 1993;270(12):1449-53.
Health care reform proposals that seek to increase access for almost 40 million uninsured Americans will require an expansion of primary care. Simply expanding available primary care services is likely to be prohibitively expensive. Developing a rational and efficient strategy for the provision of primary care to all Americans will require understanding of the relationships among primary care and access, costs, and quality--relationships that are often obscured by the complexity of the US health care system. Those relationships are examined to identify some key areas of research needed to inform policy development and improve primary care services. Despite significant gaps in our knowledge, the evidence strongly suggests that restructuring and strengthening the role of primary care practitioners in the health care system will facilitate access to affordable, high-quality health care for all Americans.
旨在让近4000万未参保的美国人获得医保的医疗保健改革提案，将需要扩大初级保健服务。仅仅扩大现有的初级保健服务可能成本高得令人望而却步。为全体美国人提供初级保健制定合理且高效的策略，将需要理解初级保健与医保覆盖、成本及质量之间的关系——这些关系常常被美国医疗保健系统的复杂性所掩盖。对这些关系进行审视，以确定一些关键的研究领域，为政策制定提供信息并改善初级保健服务。尽管我们的知识存在重大差距，但证据有力地表明，重组并加强初级保健从业者在医疗保健系统中的作用，将有助于全体美国人获得负担得起的高质量医疗保健服务。
