The diagnosis and treatment level of medically unexplained disease (MUD) in the community is closely related to the overall health service capacity of primary healthcare centers. However, general practitioners are not competent enough to diagnose and treat such diseases as shown in current studies. By combing the historical evolution of the introduction of the clinical pathway model into the field of general practice in China, this paper shows that the application of clinical pathway model in China is in a critical period of transition from simple diseases to complex diseases, and from general hospital specialties to general practice in primary care institutions, which confirms a broad application prospect in the diagnosis and treatment of MUD for clinical pathway model. This paper then summarizes the key bottleneck problems faced by the community general practice clinical pathway in China, which mainly include low recognition of clinical pathway by medical staff, difficulty in selecting types of MUD, and the inconsistency between paper form or simple electronic clinical pathway and the rapid development of medical informatization. It is further proposed on the basis that the construction of clinical pathways for diagnosis and treatment of MUD in the community should be based on general practice thinking as the core, and further exploration should be carried out and taking the clinical decision-making information platform of regional medical coordination as a new mode of clinical pathway by breaking through specialty thinking, focusing on dominant diseases, standardizing community diagnosis coding, etc. This paper provides a certain theoretical basis and strategic ideas for the future construction of clinical pathways for diagnosis and treatment of MUD in community general practice.

社区未分化疾病的诊疗与基层医疗卫生机构整体服务能力密切相关，但目前的研究表明全科医生缺乏与该类疾病相匹配的诊疗能力。本文通过梳理临床路径引入我国全科领域的历史沿革，表明国内临床路径的应用正处在由简单病种向复杂性疾病、综合性医院专科向基层医疗卫生机构全科过渡的关键时期，证实了临床路径在未分化疾病诊疗中存在广阔的应用前景，随后总结了我国社区全科临床路径正面临的关键问题主要为医务人员对临床路径重视认可度较低、未分化疾病病种选择困难及纸质表单或简单电子化式临床路径与高速发展的医疗信息化不符，在此基础上进一步提出了构建社区全科未分化疾病应以全科思维为构建核心，通过突破专科思维、聚焦优势病种、规范社区诊断编码等方式，并以区域医疗协同的临床决策信息平台作为临床路径的新模式开展进一步探索。本文为今后构建社区全科未分化疾病临床路径提供了一定的理论依据与策略思路。