三级医院中全科医学的定位和作用

2010年3月国家颁发的《以全科医生为重点的基层医疗卫生队伍建设规划》中提出，鼓励三级医疗机构建立全科医学科。2014年6月上海市卫计委批复同意同济大学附属杨浦医院(上海市杨浦区中心医院)设立全科医学执业科目，医院设立全科医学科，开设全科门诊与全科病房。全科医学科致力于健康管理、慢病管理、全科医学人才培训与学术研究等，是上海2家具备全科医学诊疗资质的三级医院之一。本文通过介绍同济大学附属杨浦医院全科医学科开设1年来门诊和病房的临床实践、总结与社区卫生服务中心的各项合作、开展多层次的人才培养和面向我国全科医学发展与社区卫生服务的科学研究这四大方面分析三级医院中全科医学的临床功能定位，即体现在为患者提供连续性、综合性，符合全科思维、全科理念的具有人文关怀的医疗服务过程；指明三级医院建立全科医学科的必要作用，为大医院与社区卫生服务中心搭建沟通桥梁，并促使双向转诊顺利进行；指导社区全科医生理论和临床知识的学习，为广大全科医生搭建高层次培训平台；探讨构建三级医院与社区卫生服务中心协同发展模式，强调三级医院的全科医学科在区域卫生协同发展中产生的重要作用，实现资源互补和资源利用最大化，推进医疗机构间的互相协作、协同发展。 

Location and role of general practice in tertiary hospital

In March,2010,China issued "the plan of team building of primary health care focusing on general practitioners",which forward to encourage tertiary institutions to establish general medicine.June,2014,Shanghai Municipal Commission of Health and Family Planning approved the Yangpu Hospital of Tongji University (Shanghai Yangpu Central Hospital) to establish general medical practice subject.The hospital set up general medicine,which includes a full general wards and outpatient clinics.This general medicine is the one of 2 tertiary hospitals,which had qualified general medical in Shanghai.General Medicine undertakes the health management,chronic disease management,general medical training and academic research.By introduce the clinical practice,the collaboration with the community health service centers,personnel training and scientific research with Community hospital,in the first year,which analyzed the clinical functional orientation of general medicine in tertiary hospitals,that is,providing continuous,comprehensive,the whole of general concept and humanistic care to patients.Indicating the necessary effects of general practice in the tertiary hospitals,which set up a bridge between tertiary hospitals and community health service center,and prompt two-way referral successfully;guiding general practitioners,perfect the knowledge of theory and training,it is the platform for the high-grade of general practitioners.Discussion building the model of coordinated development of regional health,emphasizing the important role of general medicine,promoting two-way referral smoothly,realizing complementary resources and resource utilization mainly,promoting mutual cooperation and development between medical institutions.