关键词: 全科医疗, 慢性病管理, 质量评价, 质量改进, 综述

Abstract:

Chronic diseases have become a major problem affecting the health of residents in China and globally. The improvement of the quality of general practice is of great significance to improving the management of chronic diseases in primary care. It is an important way to achieve continuous quality improvement by evaluating the quality of chronic disease management in general practice to identify the current problems. According to the review of current status of domestic and international research, some countries have established relatively complete quality evaluation systems for the management of chronic diseases in general practice. Compared with foreign countries, the practice of quality evaluation and improvement of chronic disease management in general practice in China is still in the exploratory stage, although some progress has been made, there are also some challenges: firstly, the quality evaluation of chronic disease management is mainly focused on hypertension and diabetes, insufficient attention has been paid to the clinical quality of other chronic diseases, and the degree of refinement of clinical indicators still needs to be further strengthened compared with foreign countries. Secondly, there are limitations in evaluating the practice process of chronic disease management in general practice, most of the researches were mainly limited to the performance indicators within the framework of services specification. It is possible to refine the evidence-based quality evaluation and quality improvement systems and specify monitoring indicators. Thirdly, there is still a big gap in the construction of information system in general practice, the "fragmentation" and lack of information have seriously hindered the effective evaluation of the quality of chronic disease management, the information system construction should be improved as soon as possible. Fourthly, quality evaluation results focus on feedback within the administrative system and health service providers lack awareness of their own service quality, more equitable and effective evaluation and feedback mechanisms should be explored to promote continuous improvement in the quality of chronic disease management.

Key words: General practice, Chronic diseases management, Quality evaluation, Quality improvement, Review