Grimsmo A, Iversen J H
Samfunnsmedisinsk forskningssenter, Surnadal.
Tidsskr Nor Laegeforen. 1996 Jan 20;116(2):275-7.
In Norway, primary health care is characterised by decentralisation of both care of patients and general public health services to municipal level. In all but the larger municipalities, both these services are carried out by the same primary health care doctors. In order to strengthen the quality of the doctor-patient relationship, and the associated responsibility, four municipalities are testing out a system where all inhabitants are placed on a specific doctor's list. Since the design of the test primarily emphasises the doctor-patient relationship, many community health doctors and planners are concerned about how this will affect local public health tasks. The authors discuss the experiences from these four municipalities as regards the impact on public health tasks and suggest new ways of organising public health at municipal level based on the doctors' overall responsibility for their listed patients.
在挪威,初级卫生保健的特点是将患者护理和一般公共卫生服务都下放到市级层面。除了较大的市政当局外,这两项服务均由同一些初级卫生保健医生提供。为了加强医患关系的质量以及相关责任,四个市政当局正在试验一种系统,即所有居民都被列入特定医生的名单。由于该试验的设计主要强调医患关系,许多社区卫生医生和规划者担心这将如何影响当地的公共卫生任务。作者讨论了这四个市政当局在公共卫生任务影响方面的经验,并基于医生对其名单上患者的全面责任,提出了在市级层面组织公共卫生的新方法。