The breadth of primary care: a systematic literature review of its core dimensions.
The breadth of primary care: a systematic literature review of its core dimensions.
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DOI：
10.1186/1472-6963-10-65
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发表时间：
2010-03-13
影响因子：
2.8
通讯作者：
Groenewegen PP
中科院分区：
文献类型：
--
作者：
Kringos DS;Boerma WG;Hutchinson A;van der Zee J;Groenewegen PP
尽管人们普遍认为初级保健是有效提供卫生保健的关键，但迄今为止还没有做出任何努力来系统地审查支持这一假设的科学证据。本研究的目的是通过确定其核心维度来检查初级保健的广度，并评估其相互关系及其与（初级）卫生系统层面结果的相关性的证据。对初级保健文献进行了系统回顾，仅限于报道原始研究或系统回顾的英文期刊。在MEDLINE、Embase、Cochrane图书馆、CINAHL、King’s Fund数据库、IDEAS数据库和EconLit中检索了2003年至2008年7月发表的研究。85项研究被确认。通过确定构成初级保健系统的十个核心维度，本综述能够深入了解初级保健作为一个多维系统的复杂性。初级保健系统的结构包括三个方面：1。治理;2. 经济状况;和3。员工的发展。初级保健过程由四个维度决定：访问;5. 护理的连续性；6. 护理协调；和7。关怀的全面性。初级保健系统的成果包括三个方面：护理质量；9. 效率护理;和10。健康方面的公平。有相当多的证据表明，初级保健通过其各个方面对整个卫生系统的绩效和健康作出贡献。初级保健系统可以被定义为一个多维度的系统，对整个卫生系统的绩效和健康做出贡献。
Even though there is general agreement that primary care is the linchpin of effective health care delivery, to date no efforts have been made to systematically review the scientific evidence supporting this supposition. The aim of this study was to examine the breadth of primary care by identifying its core dimensions and to assess the evidence for their interrelations and their relevance to outcomes at (primary) health system level. A systematic review of the primary care literature was carried out, restricted to English language journals reporting original research or systematic reviews. Studies published between 2003 and July 2008 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, King's Fund Database, IDEAS Database, and EconLit. Eighty-five studies were identified. This review was able to provide insight in the complexity of primary care as a multidimensional system, by identifying ten core dimensions that constitute a primary care system. The structure of a primary care system consists of three dimensions: 1. governance; 2. economic conditions; and 3. workforce development. The primary care process is determined by four dimensions: 4. access; 5. continuity of care; 6. coordination of care; and 7. comprehensiveness of care. The outcome of a primary care system includes three dimensions: 8. quality of care; 9. efficiency care; and 10. equity in health. There is a considerable evidence base showing that primary care contributes through its dimensions to overall health system performance and health. A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health.
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影响因子：
3.3
作者：
Atun, Rifat Ali;Menabde, Nata;Habicht, Jarno
通讯作者：
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