紐西蘭的基層醫療簡介

Introduction of Primary Health Care of New Zealand

過去十年當中，紐西蘭的醫療照護給付制度有著相當顯著的改變，基層醫療照護（primary health care）亦是改變的一部分，這樣的改變是為了降低醫療資源的分配不均及達到全民的健康。2001年2月紐西蘭的衛生署（Ministry of Health, MOH）發表了新的基層醫療照護政策（Primary Health Care Strategy, PHCS），地區醫療委員會（District Health Boards, DHBs）主導成立的基層醫療機構（Primary Health Organisations, PHOs）為推動新政策的重要組織架構。新政策包含6個努力方向：1.與社區及入會的民眾共同合作；2.確認及消除醫療資源分配不均的情形；3.提供高可近性的綜合性醫療服務，進而改善、維護及恢復民眾的健康；4.不同服務區的醫療照護合作；5.發展基層醫療照護所需的工作人力；6.使用好的資訊持續改善基層醫療照護品質。PHOs的成立並不代表紐西蘭新醫療照護政策的推動己完成，PHOs的發展也持續在進行，包括產婦的照護（Maternity care）、牙醫（dentists）及藥師（pharmacists）在內的長期目標，未來都將納入PHOs所涵蓋的服務範圍。

New Zealand’s publicly-funded health care sector has undergone significant changes in the past ten years. The primary health care has been part of these changes. The changes aim at decreasing the inequality of allocation of health resources and promoting people’s health. In February 2001, the New Zealand government published the Primary Health Care Strategy (PHCS), which provides direction for District Health Boards (DHBs) to bring about these changes. DHBs will work through Primary Health Organizations (PHOs) to achieve the health goals locally. Six key directions for PHCS operation are: (1) to cooperate with local communities and enrolled populations, (2) to identify and remove the inequalities of allocation of health resources, (3) to offer access to comprehensive services to improve, maintain and restore people’s health, (4) to coordinate health care across different service areas, (5) to develop the workforce for primary health care, and (6) to continuously improve quality of primary health care by proper information. The establishing of PHOs does not mean the end of implementing the PHCS, and fields for future development of PHOs are still under discussion. Even the maternity care, dentists and pharmacists will be brought into PHOs in the long term.