机译
详细说明初级保健势在必行的记忆芭芭拉星菲尔德
摘要:Barbara starfield built the field of primary care research and galvanized research and policy documenting the central importance of primary care in health and health care delivery. Her work spanned decades, showing how primary care improves population health and lowers health care expenditures. It guided many of us in the quest to improve health and health care, and rates of publications with primary care in the title have more than doubled from fewer than 1,000 in 2005 to more than 2,000 in 2018. The remarkable and comprehensive review that Starfield and her colleagues, Shi and Macinko, published in 2005 in the Milbank Quarterly1 summarized a wealth of US and international studies demonstrating that a) health is better in areas with more primary care physicians, b) people who receive care from primary care physicians are healthier, and c) the main characteristics of primary care are associated with better health. Those studied characteristics are first contact care, holistic person‐focused care over time, comprehensive care, and coordinated care, concepts expanded in various primary care medical home criteria at the national and state levels. Furthermore, better health outcomes are found in communities and countries that distribute health resources equitably, have no or low copayments for health care, have a universal financing mechanism guaranteed by a publicly accountable body (government or government‐regulated insurance plans), and have professional incomes for primary care physicians comparable to those for other specialists. Systems with strong primary care orientation and where primary care physicians are identified as the usual source of care are associated with decreased racial and socioeconomic health disparities and with decreased deaths from premature mortality, infant mortality, and overall mortality from chronic pulmonary disease, cardiovascular disease, and heart disease.