PDF(Pubmed)
Abstract：
Many people face problems about physical, mental, and social dimensions of health, and may have complex needs. They often experience a mismatch between their needs and the ability of the healthcare system to meet them, resulting in under- or overutilization of the healthcare system. On one hand, improving access to community-based primary healthcare for hard-to-reach populations should bring all healthcare and social services to one point of contact, near the community. On the other hand, better addressing the unmet needs of people who overuse healthcare services calls for integrated care among providers across all settings and sectors. In either case, intersectoral action between healthcare and social professionals and resources remains central to bringing care closer to the people and the community, enhancing equitable access, and improving health status. However, efforts to implement integrated care are unevenly weighted toward clinical and professional strategies (micro level), which could jeopardize our ability to implement and sustain integrated care. The development of appropriate policies and governance mechanisms (macro level) is essential to break down silos, promote a coherent intersectoral action, and improve health equity.
摘要：
许多人面临身体问题，心理，和健康的社会层面，可能有复杂的需求。他们经常经历他们的需求和医疗保健系统满足他们的能力之间的不匹配，导致医疗保健系统利用不足或过度。一方面,改善难以到达的人群获得基于社区的初级医疗保健的机会，应该使所有医疗保健和社会服务成为一个联系点，社区附近。另一方面,更好地解决过度使用医疗保健服务的人们的未满足需求，需要在所有环境和部门的提供者之间进行综合护理。无论哪种情况,医疗保健和社会专业人员之间的部门间行动和资源仍然是使护理更接近人民和社区的核心，加强公平准入，改善健康状况。然而,实施综合护理的努力在临床和专业策略(微观层面)上权重不均，这可能会危及我们实施和维持综合护理的能力。制定适当的政策和治理机制(宏观层面)对于打破孤岛至关重要,促进协调一致的部门间行动，改善健康公平。
