重视第四级预防 构建五级预防理论框架

Importance of fourth-level prevention strategy and theoretical framework construction for five-level prevention:a brief discussion

四级预防策略(零级、第一级、第二级及第三级预防)分别对应于疾病的不同发展阶段,已在中国疾病预防控制实践中发挥了巨大的作用。第四级预防指确定医疗机构中可能出现过度医疗及医源性疾病风险的个人(群体)通过干预降低或避免额外的医疗入侵,对不同的疾病发展阶段和医学干预阶段的预防策略进行分级,构建五级预防理论框架,可更加精准地指导我国的公共卫生及医学实践。为此,本文简要回顾了中国现有的预防策略,对第四级预防的概念和内涵进行了系统阐述,完善了五级预防理论框架,以期为中国疾病预防控制工作提供新的理论依据。

The four-level prevention strategy(including the zero level prevention,primary prevention,secondary prevention,and tertiary prevention)corresponding to different stages of a disease has played a huge role in the practice of disease prevention and control in China.Quaternary prevention aims to identify individuals(groups)at the risk of overmedication or iatrogenic diseases and decrease or avoid excessive medication and sanitary intervention through intervention.By grading prevention strategies at different stages of a disease development or medical intervention and constructing a fivelevel prevention theoretical framework,public health practices and medical services in China could be under more accurate guidance.The study briefly reviewed the development of prevention strategies in China,systematically explained the concept and connotation of fourth-level prevention and summarized the theoretical framework of five-level prevention for providing a theoretical basis to disease prevention and control practice in China.