充分发挥突发公共卫生事件中家庭医生的社区防控作用

突发公共卫生事件具有无法准确预测性、影响的广泛性和防控的复杂性等特点,社区防控是公共卫生体系中重要的基层网络,家庭医生在应对突发公共卫生事件时要继续做好居民健康的守门人,为签约居民提供高质量、综合的、持续的和个体化的保健和健康教育服务,针对医疗设施调整、慢性病患者就医不便、疫情期间特殊的心理问题和生活方式改变等问题,家庭医生应积极发挥家庭医生签约服务的优势,加强对患者的咨询和指导,及时发现和尽可能地解决患者可能存在的健康问题,提供适宜的医疗服务。此外还要做好突发公共卫生事件防控的守门人,早发现早报告,承担防控相关任务如重点人群排查与健康指导、隔离观察人员规范管理、宣传科学防护知识、发现并协调处理社区中存在的风险点等。突发公共卫生事件会导致家庭医生的防护行为、医疗行为出现一定的改变,如增加自身防护行为、更多转诊患者、提高看诊速度、测量体温、更多应用信息化技术手段等。与此同时,家庭医生在应对突发公共卫生事件时也存在着缺乏防范意识、与疾病预防控制部门隔绝、主动性和规范性不足等问题,需以政府为主体,充分调动和发挥社会力量的协同作用,构建社区疫情防控的基层治理共同体,同时在初级医疗保健服务和公共卫生服务之间建立有效的伙伴关系,通过有针对性的继续教育、建立可共享信息的网络等途径进一步提升和支持家庭医生应对突发公共卫生事件的能力。 

Emphasize the role of community prevention and control of family physicians in public health emergencies

Public health emergencies have the characteristics of unpredictability, extensive influence and complexity of prevention and control. Community prevention and control is an important grassroots network in the public health system. When dealing with public health emergencies, family physicians should continue to be the gatekeeper of residents' health, providing high-quality, comprehensive, continuous and individualized health care and health education services for contracted residents. Against the problems such as adjustment of medical facilities, inconvenience for patients with chronic diseases in seeking medical care special psychological problems and lifestyle changes during the epidemic period, family physicians should give full play to the advantages of contracted services of family physicians, strengthen consultation and guidance to patients, find patients health problems in time and solve them as far as possible and provide appropriate medical services. In addition, it is also necessary to be a gatekeeper for the prevention and control of public health emergencies, detective early and report early and undertake the tasks related to prevention and control, such as investigation and health guidance for key groups, standardized management of people who are quarantined or under observation, promotion of scientific protection knowledge, discovery and coordination of risk points in the community, etc. Public health emergencies will lead to some changes in family physicians' protective behaviors and medical behaviors, such as increasing of self-protection behaviors, increasing of referral patients, improving the speed of consultation, measuring body temperature and more application of information technology. At the same time, family physicians also have some problems in dealing with public health emergencies, such as lack of awareness of prevention, isolation from disease prevention and control departments and lack of initiative and standardization. To further improve and support the ability of family physicians to cope with public health emergencies, it is necessary to take the government as the main body, fully mobilize and play the collaborative role of social forces to build a grassroots governance community for community epidemic prevention and control, build the strong relationship between primary health care services and public health services, carry out targeted continuing education and establish information network, etc.