课件：以社区为基础的卫生服务.pptVIP

* Primary care From Wikipedia, the free encyclopedia Primary care may be provided in community health centres. Primary care is a term used for the activity of a health care provider who acts as a first point of consultation for all patients. Generally, primary care physicians, nurse practitioners, chiropractors, and physician assistants are based in the community, as opposed to the hospital. Alternative names for the field are general practice and family medicine, although the terms are not synonymous. General practitioners in the United Kingdom are physicians who have completed four to five years of post-medical school training including three to four years based in hospitals and one year attached to a training general practitioner in the community. Family medicine in the United States is a physician specialty that requires a minimum of three years of residency training followed by board certification. This specialty is considered the traditional general medicine specialty in the U.S. Examples of disorders managed in primary care are: Diabetes mellitus COPD Depression Back pain Secondary care The term secondary care is a service provided by medical specialists who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists. A physician might voluntarily limit his or her practice to secondary care by refusing patients who have not seen a primary care provider first, or a physician may be required, usually by various payment agreements, to limit the practice this way. [edit] Regional differences In the United States, however, there has been a trend toward self-referral by patients for these services, rather than referral by primary care providers. This is quite different from practice in the United Kingdom and Canada, for example, where all patients must first seek care from primary care providers who will in turn decide whether to refer the patient to secondary or tertiary care providers. In Canada, secondar