不同卫生体制国家和地区慢性阻塞性肺疾病医防融合经验与启示

Experience and enlightenment of integration between medicine and prevention of chronic obstructive pulmonary disease among countries and districts with different health systems

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)已成为威胁全球人类健康的四大慢性疾病之一。加强医防融合,对延缓COPD疾病进展和降低其急性加重风险至关重要。本文基于世界卫生组织(World Health Organization,WHO)提出的慢性病创新照护框架(innovative care for chronic conditions framework,ICCC),从宏观层面的政策环境、中观层面的医疗卫生机构和社区、微观层面的患者互动3个层次4个方面,对不同卫生体制部分典型国家和地区COPD医防融合实践进行了系统概述,并基于此总结出对我国具有借鉴意义的实践经验;同时结合我国实际情况提出了相应的政策建议。

Chronic obstructive pulmonary disease(COPD)has become one of the four major chronic diseases that threaten people′s health around the world.Strengthening the integration between prevention and treatment is crucial to slow the disease progression and reduce the risk of acute exacerbation of COPD.Based on the Innovative Care for Chronic Conditions Framework(ICCC)proposed by World Health Organization(WHO),we,in this paper,conducted a systematic review on the integration between prevention and treatment of COPD among typical countries and districts with different health systems from three levels and four aspects:policy environment at macro-level,health care organization and community at meso-level,and patient interaction at micro-level;we also summarized the practical experiences which could be used as references for China and proposed some policy recommendations according to actual situation of China.