全科医疗核心特征功能定义与内涵界定研究——连续性

连续性是基础保健的一个十分重要而独特的特征,与首诊、可及性、综合性和协调性之间以一种互为基础、相互支撑、彼此强化的方式共同作用,形成基础保健的作用机制。本文首先系统梳理目前关于连续性定义与概念内涵的研究,把握连续性内涵要素,明晰服务连续性的显性要素与隐性要素之间的关系;在此基础上,遵循可控性、穷尽性和互斥性原则,厘清基础保健下连续性与其他四个特征功能的内涵边界,给出全科医疗/基础保健连续性这一特征功能的定义与内涵,为后续建立全科医疗特征功能可操作性定义奠定基础。

Study on defining and conceptualizing of general practice: The continuity of primary care

Continuity of care is one of the core attributes of primary care, which interacts with first-contact, accessibility, coordination and comprehensiveness in a mutual, supportive, and strengthening way to form an interactive mechanism of primary care. This paper first reviews the current literature on definitions and concepts of continuity of care, ascertain the key elements of continuity, and pinpoint the relationship between the dominant and recessive elements. Then, it defines the connotations of continuity of care and their boundaries in the context of primary care, according to the principles of controllability, exhaustion and exclusiveness. Finally it conceptualizes the primary care continuity to lay the foundation for further studies on operationally defining the primary care attributes of general practice.