Person-Centered Primary Health Care: Now More Than Ever

T. Epperly, R. Roberts, S. Rawaf, C. Weel, Robert A. Phillips, J. Mezzich, Y. Pongsupap, T. Ghebrehiwet, J. Appleyard
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引用次数: 5

Abstract

Background: Person-centered primary health care provides first contact care that is comprehensive, continuous, accessible, compassionate, caring, team-based, and above all else person-centered. Primary care by its very nature is integrative in design and process. It connects and coordinates care for the person and uses shared decision making to help value and respect the person’s choices as they navigate through a complex and fragmented health care system. Objectives: To demonstrate the effectiveness of primary care in achieving the triple aim of better health, better health care, and lower cost. Methods: Critical literature review and evidence based analysis of person-centered primary health care across the world. Results: Primary care is a systems integrator and improves both the quality of care and the lowering of cost to both people and populations. It has been found that the better a country’s primary care system is, the country will have better overall health care outcomes and lower per capita health care expenditures. Evidence also demonstrates that person-centeredness contributes to higher quality care and better health outcomes. Comprehensiveness of care leads to better health outcomes, lower all-cause mortality, better access to care, less re-hospitalization, fewer consultations with specialists, less use of emergency services, and better detection of adverse effects of medical interventions. The use of the relationship of trust established through primary care health professionals in shared decision making is an effective and efficient means to promote behavior change that results in the triple aim of better health, improved healthcare, and lower costs. Conclusions : All nations must build a robust and vibrant person-centered primary health care system based on the principles of continuity, comprehensiveness, and person-centeredness. This is important now more than ever to prioritize and rebalance health care systems to address the health care needs of the people that are served.
以人为本的初级卫生保健:现在比以往更重要
背景:以人为本的初级卫生保健提供全面的、持续的、可获得的、富有同情心的、关怀的、以团队为基础的、最重要的是以人为本的首次接触保健。初级保健就其本质而言,在设计和过程上是一体化的。它连接和协调对患者的护理,并使用共同决策来帮助重视和尊重患者在复杂和分散的医疗保健系统中做出的选择。目的:证明初级保健在实现更好的健康、更好的保健和更低成本的三重目标方面的有效性。方法:对世界各地以人为本的初级卫生保健进行批判性文献综述和循证分析。结果:初级保健是一个系统集成商,既提高了护理质量,又降低了人员和人群的成本。研究发现,一个国家的初级保健系统越好,该国的总体卫生保健结果就会越好,人均卫生保健支出也会越低。证据还表明,以人为本有助于提供更高质量的护理和更好的健康结果。全面的护理可带来更好的健康结果、更低的全因死亡率、更容易获得护理、更少的再住院、更少的专家咨询、更少的急诊服务,以及更好地发现医疗干预措施的不良影响。利用初级保健卫生专业人员在共同决策中建立的信任关系是促进行为改变的有效手段,从而实现更好的健康、改善的医疗保健和降低成本的三重目标。结论:所有国家都必须在连续性、全面性和以人为本的原则基础上,建立健全和充满活力的以人为本的初级卫生保健系统。现在比以往任何时候都更重要的是优先考虑和重新平衡卫生保健系统,以满足所服务人群的卫生保健需求。
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