JACC:安贞医院马长生等——中国医疗体系呈“倒金字塔”型,不能持续发展

2019-06-21 xujing 文韬 中国循环杂志

北京安贞医院杜昕和马长生等在JACC撰文称,目前中国医疗体系呈“倒金字塔”型,这样根本不能持续发展,防治心血管病,亟需策略性改变。

北京安贞医院杜昕和马长生等在JACC撰文称,目前中国医疗体系呈“倒金字塔”型,这样根本不能持续发展,防治心血管病,亟需策略性改变。

作者指出,长期以来,我国的医疗体系注重急性病的治疗(见下图),忽视了慢病管理,基层卫生保健体系薄弱,无法有效控制心血管危险因素,不能预防心血管病的发病。



图 中国医疗体系的呈“倒金字塔“形,最好应该呈右边的正金字塔形

作者认为,中国医疗体系缺乏有效的分级结构,医务人员负担沉重,疲惫不堪,不能提供高质量的医疗服务。

比如,2001年至2011年,ST段抬高型心肌梗死患者的住院率增加了约4倍,同一时期,急性心肌梗死、经皮冠状动脉介入治疗大幅增加。

另外,不恰当地诊断加重医疗负担。比如,在非三级医院和三级医院中,仅在5%和3%的疑似急性冠状动脉综合征患者接受了运动试验,而冠脉造影的比例达到31%和63%。

目前,中国冠心病、缺血性卒中、出血性卒中和高血压心脏病的年龄标准化死亡率明显高于美国和西欧,过早死亡率也明显较高。

作者认为,要应对这些挑战,改变现状,应该从国家层面将医疗卫生事业作为优先事项,并采取了改革措施,包括实施健康环境政策、加强基层医疗保健、提高卫生系统的负担能力和可及性。


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    2019-08-28 hbwxf
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    2019-06-22 txqjm

    谢谢了,学习

    0