基于CiteSpace的我国基层首诊研究现状及趋势分析

目的 系统梳理我国基层首诊研究的现状及趋势，推动后续研究和基层首诊有效实施。方法 以“基层首诊”or“社区首诊”or“社区卫生服务&首诊”or“乡镇卫生院&首诊”or“村卫生室&首诊”为主题词，对中国知网（CNKI）数据库中CSSCI、核心期刊相关文献进行检索，用CiteSpace软件对高频作者及机构、高频关键词及其聚类、突现词进行分析。结果 纳入1997—2020年发表的326篇文献，年发文量总体呈上升趋势，研究合作网络相对分散；研究经历了起步研究（1997—2005年）、实施研究（2006—2015年）和健全基层卫生服务体系研究（2016—2020年）三个阶段，研究关注点从基层首诊的实施基础到实施，再到综合体系运行；主要研究方向为基层首诊服务要素、实行效果评价和分级诊疗相关研究。结论 基层首诊研究逐步深入，应加强跨区域、跨机构的合力研究，医联体治理、签约服务个性化、医保支付改革、智慧医疗体系建设、医康养服务能力、社会办医助力基层服务体系等是未来主要研究方向。

Current situation and trend analysis of primary treatment in China based on CiteSpace software

Objective To systematically review the current situation and trend of primary treatment research in China, and to promote further research and effective implementation of primary treatment. Methods With the subject term of “primary treatment”, “community first treatment”, “community health service & first treatment”, “township hospitals & first treatment”or “village clinics & first treatment”, the relevant research papers published in Chinese core journals and CSSCI in CNKI database were retrieved. CiteSpace was used to analyze high-frequency authors and institutions, keywords and their clustering, and burst terms. Results A total of 326 papers from 1997 to 2020 were included. The volume of annual publications was generally on the rise. Research teams were relatively scattered. The progress of research was divided into the initial stage(1997-2005), the implemented stage(2006-2015), and the stage of improving the primary health service system(since 2016). The research focus of primary treatment shifted from the basic to implementation and then to the operation of the comprehensive system. The main research topics included primary treatment service elements,implementation effect evaluation and the hierarchical treatment, and treatment system. Conclusion The research on primary treatment is gradually deepening, and the research on cross-regional and cross-institutional synergy should be strengthened;the governance of medical association, personalization of contracted services, health insurance payment reform, construction of intelligent medical system, medical and recreational service capacity, and socially run medical services to help primary diagnosis service system are the main research directions in the future.