Iliffe S
Department of Primary Health Care, University College London Medical School, UK.
Postgrad Med J. 1996 Apr;72(846):201-6. doi: 10.1136/pgmj.72.846.201.
The UK is unusual in providing universal free healthcare in which access to specialists is largely controlled by general practitioners with 24-hour responsibility, throughout the year, for a defined list of patients of all ages. It is generally considered that this gatekeeper function has contributed to the relatively low cost of the National Health Service, but major changes in the organisation and clinical role of general practitioners have occurred, culminating in a new contract that aims to re-orientate general practice towards health promotion, disease prevention and the management of chronic disease. The implications of these changes are discussed.
英国在提供全民免费医疗保健方面与众不同，在这种体系中，专科医生的诊疗机会很大程度上由全科医生掌控，全科医生全年365天、每天24小时负责特定年龄段的患者名单。人们普遍认为，这种把关人功能有助于降低国民医疗服务体系的成本，但全科医生的组织架构和临床角色已发生重大变化，最终形成了一项新合同，旨在使全科医疗重新转向健康促进、疾病预防和慢性病管理。本文将讨论这些变化的影响。
