"越洋病例讨论"是杂志2010年搭建的一个新的全科医疗国际学术交流的平台。通过对国外家庭医学经典案例的点评和分析,引发中国全科医生的思考,在借鉴的基础上更好地诠释全科医学理念和整体服务的思想。本栏目的系列病例由美国..."越洋病例讨论"是杂志2010年搭建的一个新的全科医疗国际学术交流的平台。通过对国外家庭医学经典案例的点评和分析,引发中国全科医生的思考,在借鉴的基础上更好地诠释全科医学理念和整体服务的思想。本栏目的系列病例由美国威斯康星大学的Kushner教授(Kenneth Kushner,Ph.D.Professor Department of Family Medi-cine,University of Wisconsin)提供;翻译和组织工作由北京市东城区社区卫生服务管理中心谢载纬医生(Dr.GilbertShia)担任,在此对他们给予的大力帮助和支持表示衷心的感谢!欢迎中外广大的全科医生将实际工作中的问题以病例讨论的形式发给我们,由杂志组织专家对您的病例展开讨论。投稿或参加评论请注明"越洋病例讨论",病人姓名和就医地点应保密,不必上传。Cases should be submitted by post or email to the editorial office,and clearly marked for"International Case Discussion".The names of patients and institutes are confidential and should be removed before thetext is submitted;栏目信箱:xuyanli@vip.sina.com;地址:北京市宣武区广义街广益大厦A座907室"越洋病例讨论"栏目组。展开更多
Objective:This article describes the implementation of a population-based strategy to man-age depression in a patient-centered medical home.Methods:Review of English language articles;description of specific protocols...Objective:This article describes the implementation of a population-based strategy to man-age depression in a patient-centered medical home.Methods:Review of English language articles;description of specific protocols utilized in one medical home.Results:Depression is a global concern estimated to affect 350 million people worldwide.Rates for depression vary between the United States and the Peoples’Republic of China,possibly due to significant factors in under diagnosis of this often hidden burden.Given the comorbidity of depres-sion with other health factors and the need for ongoing monitoring and care of this chronic illness,primary care has become a significant part of treatment interventions.Utilizing electronic health records(EHR),our strategy included the creation of a patient registry;selection of evidence-based treatment guidelines and protocols for point of care procedures;patient outreach and screening.Conclusion:The population-based program we outline is highly dependent on the EHR and the flexibility of roles and responsibilities of clinical staff.Further investigation is warranted into improved patient outcomes.展开更多
Objective:Although the literature is abundant on traditional Chinese medicine(TCM)in the West,there is limited information on how TCM is integrated with Western medicine(WM).We describe how one Chinese Community Healt...Objective:Although the literature is abundant on traditional Chinese medicine(TCM)in the West,there is limited information on how TCM is integrated with Western medicine(WM).We describe how one Chinese Community Health Service(CHS)system located in Beijing integrates WM and TCM.Methods:Our information is based on the authors’observations,interviews with center TCM practitioners,and discussions with center administrators.Results:We summarize our observations according to the following themes:selection of type of practitioner;frequent diagnoses of patients seen by TCM clinicians;types of TCM ser-vices provided;economic factors;challenges;and future directions.Patient age,nature of the problem,and cost may determine whether or not Chinese patients initially consult TCM or WM practitioners.Because of referral pathways between the WM and TCM practitioners,up to one-third of the patients receive integrated care.TCM physicians see more patients per day than do their WM counterparts;TCM physicians also earn higher salaries.Although there are clearly close collaborative relationships between the TCM and WM practitioners,a few TCM providers report that lack of respect between the two fields may be a barrier towards further integration.Conclusion:Given governmental policies and the cost differentials between WM and TCM,the future for the integration of the two medical traditions within the CHS system appears to be favorable;however,issues of mutual respect and workforce issues may challenge success-ful integration.Our impressions are limited by the fact that we observed practices in only one community in one district of Beijing.展开更多
文摘"越洋病例讨论"是杂志2010年搭建的一个新的全科医疗国际学术交流的平台。通过对国外家庭医学经典案例的点评和分析,引发中国全科医生的思考,在借鉴的基础上更好地诠释全科医学理念和整体服务的思想。本栏目的系列病例由美国威斯康星大学的Kushner教授(Kenneth Kushner,Ph.D.Professor Department of Family Medi-cine,University of Wisconsin)提供;翻译和组织工作由北京市东城区社区卫生服务管理中心谢载纬医生(Dr.GilbertShia)担任,在此对他们给予的大力帮助和支持表示衷心的感谢!欢迎中外广大的全科医生将实际工作中的问题以病例讨论的形式发给我们,由杂志组织专家对您的病例展开讨论。投稿或参加评论请注明"越洋病例讨论",病人姓名和就医地点应保密,不必上传。Cases should be submitted by post or email to the editorial office,and clearly marked for"International Case Discussion".The names of patients and institutes are confidential and should be removed before thetext is submitted;栏目信箱:xuyanli@vip.sina.com;地址:北京市宣武区广义街广益大厦A座907室"越洋病例讨论"栏目组。
文摘Objective:This article describes the implementation of a population-based strategy to man-age depression in a patient-centered medical home.Methods:Review of English language articles;description of specific protocols utilized in one medical home.Results:Depression is a global concern estimated to affect 350 million people worldwide.Rates for depression vary between the United States and the Peoples’Republic of China,possibly due to significant factors in under diagnosis of this often hidden burden.Given the comorbidity of depres-sion with other health factors and the need for ongoing monitoring and care of this chronic illness,primary care has become a significant part of treatment interventions.Utilizing electronic health records(EHR),our strategy included the creation of a patient registry;selection of evidence-based treatment guidelines and protocols for point of care procedures;patient outreach and screening.Conclusion:The population-based program we outline is highly dependent on the EHR and the flexibility of roles and responsibilities of clinical staff.Further investigation is warranted into improved patient outcomes.
文摘Objective:Although the literature is abundant on traditional Chinese medicine(TCM)in the West,there is limited information on how TCM is integrated with Western medicine(WM).We describe how one Chinese Community Health Service(CHS)system located in Beijing integrates WM and TCM.Methods:Our information is based on the authors’observations,interviews with center TCM practitioners,and discussions with center administrators.Results:We summarize our observations according to the following themes:selection of type of practitioner;frequent diagnoses of patients seen by TCM clinicians;types of TCM ser-vices provided;economic factors;challenges;and future directions.Patient age,nature of the problem,and cost may determine whether or not Chinese patients initially consult TCM or WM practitioners.Because of referral pathways between the WM and TCM practitioners,up to one-third of the patients receive integrated care.TCM physicians see more patients per day than do their WM counterparts;TCM physicians also earn higher salaries.Although there are clearly close collaborative relationships between the TCM and WM practitioners,a few TCM providers report that lack of respect between the two fields may be a barrier towards further integration.Conclusion:Given governmental policies and the cost differentials between WM and TCM,the future for the integration of the two medical traditions within the CHS system appears to be favorable;however,issues of mutual respect and workforce issues may challenge success-ful integration.Our impressions are limited by the fact that we observed practices in only one community in one district of Beijing.
