The concept of"healthy ageing"aims to enhance the health and quality of life of older adults,yet it also constructs normative standards for"ideal ageing",which may inadvertently impose pressure on elderly individuals' sense of subjectivity.Drawing on Foucault's concept of knowledge-power,this study reveals the identity struggles among older adults partly stem from sociocultural expectations embedded in health discourses.Building further on Foucault's later notion of"care of the self',the paper reimagines old age as an ideal period for the cultivation of life as an art and for autonomous self-discipline.It explores how elderly individuals can assign new meaning to late life through care of the self,by actively pursuing health while also embracing natural ageing,thus preserving both dignity and subjectivity.Healthy ageing policies,therefore,should not only offer proactive support but also respect individual differences and personal choices,avoiding the transformation of well-intentioned interventions into new forms of constraint.This approach aims for a dual achievement:improving life quality while safeguarding the dignity of the ageing population.

Background:The World Health Organization (WHO) has made significant efforts to promote age-friendly community initiatives (AFCI) to address the challenges of population aging. Previous studies have discussed the construction of age-friendly communities (AFC) in urban cities, evaluating AFCs often rooted in the WHO's Checklist and focused on a single group, namely older adults, overlooking the role of other age groups in community development. Objective:This study aims to evaluate AFCs from multidimensional aspects, particularly the positive living experiences of older adults, summarize the deficiencies in both hardware and software aspects in the process of constructing AFCs in China, and provide some recommendations to promote AFCIs worldwide. Methods:Using a multistage sampling strategy, 470 community residents from urban and suburban areas participated in this study. A self-designed questionnaire was designed to use a standardized method to evaluate older adults' living experiences across five dimensions, including the degree of age-friendliness in the community, social support, sense of gain, sense of happiness, and sense of security. Respondents rated each dimension on a 10-point scale. This study defined community residents into 3 groups: residents younger than 45 years(Group 1: youth), those aged 45-59 years (Group 2: middle-aged), and those aged ≥60 years (Group 3: old-age). Results:In this study, 382 (81.3%) community residents were unaware of the relevant concepts of AFCs. Most participants highlighted the importance of community support and health services, followed by respect and social inclusion, and outdoor spaces and buildings. The findings showed that the highest-rated dimension was the sense of security. The mean scores for the degree of the sense of security in urban and suburban areas were 7.88 (SD 1.776) and 7.73 (SD 1.853), respectively. For Group 2, the mean scores were 7.60 (SD 2.070) and 8.03 (SD 1.662), while Group 3 had mean scores of 7.34 (SD 2.004) and 7.91 (SD 1.940). The lowest-rated dimension was social support; the mean scores for Group 1 for the degree of social support in urban and suburban areas were 7.63 (SD 1.835) and 7.48 (SD 1.918), respectively. For Group 2, the mean scores were 6.94 (SD 2.087) and 7.36 (SD 2.228), while those for Group 3 were 6.37 (SD 2.299) and 6.84 (SD 2.062). Further, there were significant differences in the scores of residents among different age groups in urban areas regarding age-friendliness (P<.001), social support, (P<.001), and sense of gain (P=.01). Conclusions:China is in the early stages of developing AFCs. We further highlight the importance of continued research on the collaboration and participation among multiple stakeholders. These outcomes have a direct and positive impact on the well-being of older adults.

Background With the conflict between the promise of ageing in health and longevity and the limited availability of health resources and social support, older adults in China inevitably experience anxieties surrounding health risks. This study aims to investigate how older adults perceive the health risks that come with getting older, explore the degree to which health risks affect older adults, and advocate for active engagement in practices for managing health risks.Methods Using purposive sampling, three districts of Beijing (Xicheng District, Fengtai District, and Daxing District, respectively) were selected for the research. Qualitative semi-structured and in-depth interviews were conducted with 70 community-dwelling older adults who participated in the study. Data were extracted and analyzed based on a thematic framework approach.Results Three main themes were identified: (i) the anxieties of older adults concerning health risks in ageing; (ii) the priorities of older adults for health risk management in ageing; (iii) the expectations of older adults for health risk management in ageing. The primary health concerns among older adults included disease incidence and function decline. It was found that basic health management emerged as a critical need for older adults to mitigate health risks. Moreover, it was observed that healthcare support for older adults from familial, institutional, and governmental levels exhibited varying degrees of inadequacy.Conclusions The primary source of anxieties among older adults regarding health risks predominantly stems from a perceived sense of health deprivation. It is often compounded by persistent barriers to primary care of priorities in managing health risks among older adults. In addition, the expectations of older adults for health risk management emphasize the necessity for integrated care approaches. Therefore, further research should give priority to the prevention and management of health risks, aim to reduce anxieties, provide integrated care to meet the primary needs and expectations of older adults, and ultimately strive toward the overarching goal of promoting health and longevity.

Person-centered primary care measures (PCPCM) facilitate high-quality and culturally appropriate primary care. Access to PCPCM remains unequal between rural and urban areas, and the available evidence on rural PCPCM is still lacking. A cross-sectional survey was conducted with stratified sampling by regions, and four districts (Xicheng, Fengtai, Huairou, and Daxing) in Beijing were selected to test the performance of PCPCM in both urban and rural areas. Descriptive statistical methods were used to compare the urban-rural differences in the demographic characteristics of PCPCM. Correlation and regression analyses were performed to determine the associations between PCPCM in demographics and utilization of primary care. The PCPCM showed good reliability and validity in both urban and rural areas (P < .001), slightly lower in rural areas, but scores of rural PCPCM (R-PCPCM) in all items were lower than urban PCPCM (U-PCPCM). Patients in either the preferred urban or rural health centers all showed the highest PCPCM scores, with U-PCPCM= 3.31 for CHCs and R-PCPCM= 3.10 for RHCs, respectively. Patients in urban areas were more likely to receive higher-quality primary care than in rural areas (P < .001). Patients who preferred hospitals (beta = 2.61, P < .001) or CHCs (beta = 0.71, P = .003) as providers was a significant positive predictor of U-PCPCM but it was the preference for hospitals (beta = 2.95, P < .001) for R-PCPCM. Urban-rural differences existed in the performance of PCPCM, with rural areas typically more difficult to access better PCPCM. To promote health equity in rural areas, healthcare providers should strive to minimize urban-rural differences in the quality and utilization of primary care services as much as feasible.

"互联网+"的多维嵌入,使医疗领域的运行环境、服务方式、人际关系出现新的演变,推动传统的面对面就诊和医生占据主导地位的交往模式发生变革.基于医患双向视角,以"互联网+医疗"下利益相关者的诉求为切入点,分析"互联网+"对医患关系的双重影响,探索"互联网+"背景下医患关系的重构对策.研究发现:医生对"互联网+医疗"认知度不高,致使服务供给范围受限;患者对"互联网+医疗"认知度偏低,导致服务受众范围偏窄;"互联网+医疗"有助于提升医患双方资源的可及性;"互联网+医疗"存在致使医患双方风险递增的可能性.对此,提出如下改进对策:强化政府的监督管理,推动医患双方在线安全互动和有序交往;严查互联网平台的医生资质与信息管理,保障医患双方的合法权益;培育医生的医学人文素养,改善医患非技术层面的交往关系;提升患者的个人健康素养,秉持对医生和服务的适宜期许;敦促媒体客观公正的宣传报道,营造医患互信的良善氛围.

目的:构建社区老年照护关怀体系,以期改善老年人的生存质量,为我国积极应对健康风险冲击下的老龄化社会提供行动框架.方法:在文献研究的基础上采用逻辑归纳法,分析我国老年健康照护模式的现存困境,提出健康风险冲击下的社区老年照护应对路径.结果:老年人作为卫生服务领域的弱势群体,其健康处于持续衰退阶段,健康风险特征呈现多元化的发展趋向.老年人对照护依赖的需求持续增长,亟需来自多主体供给的照护关怀.结论:建立并拓展全生命周期连续的社区老年照护关怀体系,有助于实现老年疾病预防的关口前移,缓解老龄期健康风险对老年人功能发挥的影响,以助力健康老龄化和积极老龄观的实现进程.

通过探究公共场所自动除颤仪(automated?external?defibrillator,?AED)配备义务的伦理与法理困境,发现公共场所AED配置率低与公众健康素养低已成为院外心脏骤停救治率低的双重挑战.借鉴道义论与功利论,剖析公共场所AED配备的伦理价值,总结公共场所AED配备的相关政策法规,分析各地AED配置的政府责任履行和社会参与程度,并厘清责任主体,调和不同主体间义务履行的利益冲突.建议推动公共场所AED配备成为一项普遍义务,以弥合发达与欠发达地区公共场所AED配置"鸿沟",促进公共卫生资源的公正分配与公众健康受益的平等性.

目的 探讨生命伦理学视阈下"互联网+医疗"模式中患方权益保障问题,为其良性发展提供参考意见.方法 通过目的抽样法在北京市对 25 名居民和 33 名医生进行半结构化的个人深入访谈,采用主题框架法对访谈资料进行定性分析.结果 "互联网+医疗"对患方隐私保护能力较差,获取知情同意较难,难以践行公平原则,其尚未达到对患者利益保护的最大化.结论 应从法律政策、互联网技术、医生行为等多层面保障"互联网+医疗"模式下的患者就诊权益.

目的:分析北京市某社区中重度失能老年人家庭医生签约服务及相关中医药服务的利用情况,提出家庭医生签约服务的改进对策.方法:选取2019年1-12月某城市社区≥65岁且符合中重度失能评判标准的162例老年人作为研究对象,采用社区卫生服务机构健康档案数据提取和自制调查问卷结合的方法,通过电话调查方式对中重度失能老年人进行调查,总结该社区失能老年人家庭医生签约服务利用现状及存在的问题,结合国际经验和国内实践,提出针对性的对策建议.结果:该社区失能老年人通过家庭医生签约服务的中医药体质干预,使偏颇体质转变为平和质,

新冠疫情发生后,作为社区卫生服务机构中坚力量的家庭医生与各级政府及卫生行政部门通力协作,实施群防群治、联防联控,积极发挥居民"健康守门人"及"疫情防控的前沿哨点"作用.家庭医生在抗疫期间尽管面临常规签约服务中连续性契约式服务关系间歇中断、个人身体机能和工作效率同步衰减、继续教育和进修学习搁浅放缓等现实困境,但他们仍然在筑牢疫情防控"网底"中,积极展现"敬佑生命、救死扶伤"的职业精神;在突发公共卫生事件应急救援中,勉力践行"甘于奉献、大爱无疆"的使命宗旨.在疫情常态化防控时期,医师职业精神对于家庭医生而言,依然需要做到践行不懈并实现日益精进.针对家庭医生的医师职业精神、职业道德规范等他律举措,如何实现从他律走向自律,需要家庭医生在长期的诊疗实践中将制度和舆论监督转变成自身执业时的内心信念,内化为自觉的行为,提升其对医德义务和医德责任的自觉认识与情感认同.在抗疫过程中,家庭医生充分意识到自身职业角色和防疫服务的重要社会价值,并在全方位投入抗疫实践中不断调适执业行为,从而逐渐认同了自己的执业理念,坚持用行动践行利他主义精神.

Objective To evaluate the current state of family doctor contract services (FDCS) in Beijing, identify the roles of family doctors who have worked with disabled older adults and investigate the barriers and facilitators faced by family doctors in providing care for them. Design A convergent mixed methods study was carried out from October 2020 to January 2021 to collect and analyse both quantitative and qualitative data. The integration strategies in this study were connecting the results of the quantitative phase to data collection of the qualitative phase. Setting A multi-stage sampling strategy was used to select 15 community health centres (CHCs) in four districts of Beijing. Of the four districts, two were from urban areas and two were from rural areas. Participants The inclusion criteria for participants were (1) family doctors, (2) contracted with disabled older adults, (3) engaged in related work for disabled older adults more than 6 months. Methods A cluster sampling of 283 family doctors was used in the questionnaire. A purposive sample of 30 family doctors from the same CHCs was selected during the same period. Frequency and rank, rank-sum test, Kruskal-Wallis test were conducted in qualitative data analysis, the views of the interviewees were analysed through the thematic framework method. Results Currently, family doctors provided various services to satisfy the health needs of disabled older adults, while the usage of FDCS for disabled older adults is affected by many factors. The differences of the importance of family doctors' role (p<0.001) and service satisfaction (p=0.004) were significant among four districts. Compared with contracted health senior citizens, this study has identified five unique roles of family doctors, including 'psychological consultant', 'rehabilitation physiotherapist', 'health educator', 'health manager' and 'family health guardian'. Moreover, family doctors are confronted with a myriad of barriers (including high risks in the process of home visits, a lack of supervisory and incentive mechanisms, insufficiency of time and energy, etc) and facilitators (including establishing a doctor-patient trust relationship, developing humanistic care services, etc) in the FDCS for disabled older adults. Conclusions Family doctors play a pivotal role in the FDCS for disabled older adults, while the effect and quality of FDCS in China needs to be improved. It is suggested that further research needs to focus on solving existing barriers of FDCS to optimise the health of disabled older adults and improve the quality of their lives.

Objective:In light of the professional performance of healthcare personnel during the prevention and control of COVID-19 pandemic, this study aims to analyze current status of the professional cognition, professional emotion, professional volition and professional literacy, which would inform the cultivating of medical professionalism among medical students.Methods:A qualitative research method was adopted. From March to May 2021, a semi-structured and personal in-depth interviews was conducted with 60 undergraduate medical students of clinical medicine, stomatology, pediatrics and nursing enrolled from 2018 to 2020 at a medical college in Beijing, and the qualitative data were analyzed using the content analysis method.Results:Four major themes were extracted: during pandemic, in terms of professional cognition: the majority of medical students had a low level of perception of medical professionalism; in terms of professional emotion: most medical students thought that doctor′s profession was noble and had a strong sense of professional identity; in terms of professional volition: most medical students thought that the prospect of doctor′s profession was good and they had a clear desire to pursue medicine; in terms of professional literacy: the medical humanities literacy of most medical students was poor and they had difficulty combining theoretical knowledge with clinical practice.Conclusions:During the COVID-19 pandemic, medical colleges and universities should focus on education of medical professionalism, strengthen medical students′ professional cognition; medical education should promote the spirit of the era′s role models to enrich medical students′ professional emotions, encourage them to stay true to the mission of entering medical college and to forge their professional will; medical students should exercise their clinical practice abilities, strive to improve their professional quality and lay a solid foundation for their future career.

目的 建立一套契合于山区特征的社区卫生服务机构家庭医生签约服务绩效考核方案,以期达到调动山区家庭医生的服务积极性,提升签约服务效果的目的.方法 2019年9月-2020年5月,通过问卷调查、关键知情人访谈、专题小组讨论及典型个案的实地研究以描述山区家庭医生签约服务现况,设定适宜京郊山区的家庭医生签约服务绩效考核方案,并评价方案在机构的实际应用效果.其中,定性资料采取主题框架法、内容分析法等进行描述性分析和解释性分析.结果 完成社区卫生服务机构家庭医生签约服务绩效考核方案的设计,以标准化工作量法和目标管理法相结合的方式,从服务数量、服务质量、满意度及目标完成情况4个方面对山区家庭医生签约服务进行考核.开展个案研究的琉璃庙镇社区卫生服务中心签约居民对家庭医生签约服务的认知度、满意度、签约知晓率分别从2019年的55.00％(排名第12)、50.00％(排名第9)、60.00％(排名第4)跃升至2020年度的92.00％、92.49％、89.80％,3项指标均位居全区16家社区卫生服务中心第1名.结论 构建符合山区工作特点的家庭医生签约服务绩效考核方案可以达到调动家庭医生工作积极性、推进家庭医生签约服务工作良性发展的目的.

新冠肺炎疫情的全球蔓延,说明培育公共健康意识、构建人类卫生健康共同体理念已成为当前社会情境下的应急之需和长远之计.唯有秉持人类卫生健康共同体理念,加强个人、家庭、社区、机构、城乡、国家等之间的通力协作,以点带面织密织牢基层防控"网底",建立群防群控、联防联控机制,才能彻底遏制疫情在全球的蔓延.在人类卫生健康共同体这一发展理念和价值取向下,个体既是公共健康的助力者,亦是公共健康的构成者,更是公共健康的受益者.公共健康的实现离不开每个个体的身体力行,需要全体公民在人类卫生健康共同体理念和个体健康首责意识的引领下,形塑契合于个体自身境况的健康促进行为,促成全社会自觉遵循的健康维护氛围,创建人人可及的健康生态环境,让全体公民共享公共健康管理的良善之果,以期达成人类卫生健康共同体的美好愿景.

BackgroundThe elderly residents in the mountainous area of northern Beijing have a high incidence of chronic diseases, a weak economic foundation, limited access to health knowledge, and a long distance from community health service institutions. At present, the team of family doctors in the mountainous area of northern Beijing is composed of community doctors and rural doctors. Both of them play an important role in contracting services for elderly residents in mountainous areas.ObjectiveTo explore the current status of family doctor contracted services in the northern mountain areas of Beijing and put forward appropriate suggestions on family doctor contracted services with the elderly residents in mountain areas.MethodsA combination of qualitative research and quantitative research was adopted. From September to October 2019, eight townships were selected in the northern mountain areas of Huairou District in Beijing. A total of 141 community doctors, 133 rural doctors and 345 elderly residents were selected proportionally from each township for questionnaire research. The elderly resident's questionnaires included basic information of the elderly, the way and the content of services which they want family doctor team to provide, the channels to obtain health consultation, and the satisfaction evaluation of the contracted services; the rural doctors and the community doctors' questionnaires included basic information, the use of internet in the contracted services, and the content of services provided to the elderly residents. During the same period, 16 cases of elderly residents, 24 cases of community doctors, and 24 cases of rural doctors were selected by using the purposive sampling method for personal in-depth interviews, in order to understand the level of awareness of the responsibilities of community doctors and rural doctors in the linkage contracted services, their views on the contracted services and the application of the internet in this service model, their suggestions on the development of the contracted services, etc. A content analysis method was used to analyse qualitative data.ResultsAccording to the quantitative research results, the top three services that elderly residents in the northern mountain areas of Beijing want the family doctor team to provide are ranked as follows: carrying out the health education in countryside〔199 (57.7%) 〕, physical examination in countryside〔197 (57.1%) 〕, the delivery of medical service and medicine in the countryside〔169 (49.0%) 〕; the top three ways or channels of services that elderly residents want the family doctor team to provide are ranked as follows: outpatient clinicservice, in-home medical services, organizing health education lectures in the community; the top three channels that elderly residents consider most effective to obtain health information are ranked as follows: publicity by rural doctors or loudspeaker in the village〔253 (73.33%) 〕, face-to-face publicity by community doctors during consultation〔134 (38.84%) 〕, posting and distribution of publicity materials〔126 (36.52%) 〕. The results of multiple linear regression analysis showed that service attitude, service effectiveness, service items, and communication ability were the influencing factors of elderly residents' satisfaction with community doctors and rural doctors' linkage contracted services (P<0.05) . The health management service, outpatient service, drug distribution and medical guidance service, and long-term prescription service also had significant differences between community doctors and rural doctors (P<0.05) . There was no statistically significant difference between community doctors and rural doctors using the Internet to communicate with residents online (P>0.05) . The qualitative research results showed that the elderly residents had low demand for online services and high dependence on rural doctors, but the technical level of rural doctors were limited, community doctors had little communication with elderly residents, and they mainly focused on the coordination of medical resources.ConclusionThe development of contracted services for elderly residents in the northern mountain areas of Beijing cannot be carried out without the joint efforts of community doctors and rural doctors. Currently, the elderly residents highly depend on rural doctors because of close-up services and show a great demand on community doctors for high-level technology and medical resources platform. It's recommended to take the needs of elderly residents as the guide, give full play to the advantages of rural doctors in terms of location and people, and the advantages of community doctors' technology and platform, and optimize the effectiveness of community doctors and rural doctors' linkage contracted services.

Abstract Background Currently, population aging has been an obstacle and the spotlight for all countries. Compared with developed countries, problems caused by China’s aging population are more prominent. Beijing, as a typical example, is characterized by advanced age and high disability rate, making this capital city scramble to take control of this severe problem. The main types of care for the disabled elderly are classified as home care, institutional care, and community care. With the obvious shortage of senior care institutions, most disabled elderly people are prone to choose home care. This kind of elderly care model is in line with the traditional Chinese concept and it can save the social cost of the disabled elderly to the greatest extent. However, home care for the disabled elderly is facing bumps from the whole society, such as lack of professional medical care, social support and humanistic care, and the care resources provided by a single subject cannot meet the needs of the disabled elderly. Objective Based on the demands of the disabled elderly and their families, this study aims to explore the current status of home care service, look for what kind of care is more suitable for the disabled elderly, and try to find an appropriate elderly care mechanism which could meet the diverse needs of the disabled elderly. Methods A total of 118 disabled elderly people and their primary caregivers were selected from four districts of Beijing by using multi-stage stratified proportional sampling method. A one-to-one and semi-structured in-depth qualitative interview were conducted in the study to find out the health status of the disabled elderly, the relationship between the disabled elderly and their primary caregivers, and utilization of elderly care resources, etc. The views of the interviewees were analyzed through the thematic framework method. All the methods were carried out in accordance with relevant guidelines and regulations. Results The results showed that the average age of 118 disabled elderly is 81.38 ± 9.82 years; 86 (72.9%) are severe disability; 105 (89.0%)are plagued by chronic diseases; the average duration of disability is 5.63 ± 5.25 years; most of disabled elderly have 2 children, but the primary caregiver are their own partner (42, 35.6%), and there is an uneven sharing of responsibilities among the disabled elderly's offspring in the process of home care. The disabled elderly enjoy medical care services, rehabilitation training, daily health care, psychological and other demands. However, the disabled elderly and their families in Beijing face a significant financial burden, as well as physical and psychological issues. The care services provided by the government, family doctors, family members and social organizations fall far short of satisfying the diverse care needs of the disabled elderly. Conclusions In order to effectively provide home care services for the disabled elderly, it is therefore necessary to establish a coordination mechanism of multiple subjects and give full play to the responsibilities of each subject. This study proposes a strengthening path for the common cooperation of multiple subjects, which taking specific responsibilities and participating in the home care for the disabled elderly: (1) The government should give full play to the top-level leading responsibilities and effectively implement people-oriented measures to the disabled elderly. (2) Family doctors strengthen their responsibilities as health gatekeepers and promote continuous health management of the disabled elderly. (3) Family members assume the main responsibility and provide a full range of basic care services. (4) Social forces promote supplementary responsibilities of public welfare and expand the connotation of personalized care services. (5) The disabled elderly should shoulder appropriate personal responsibility and actively cooperate with other subjects.

老龄化社会,高龄老人多病共存问题凸显,恶性肿瘤患病率持续攀升,改善临终患者生活质量,发展安宁疗护有着积极的现实意义.基于福利多元理论,志愿者加入到安宁疗护团队中有利于安宁疗护事业的多元化发展,通过开展志愿服务、给予临终者尊严,可以提高其死亡质量、体现社会支持;基于互助共济理论,志愿者参与安宁疗护服务有利于助推社会精神文明的改善,达到代际互助共济的良性循环.志愿者参与安宁疗护服务模式尚在逐步探索之中,旨在提出政府出台相关志愿服务政策,营造良好的社会氛围;基于知信行模式对志愿者展开教育培训、促进服务团队整体协调发展;通过达成保密协议等方式完善志愿者服务机制,提升临终者及其家属接受志愿服务的意愿程度等建议,为安宁疗护事业的可持续发展提供借鉴.

摘 要 目的：通过了解社区失能老人的服务需求现状，评价家庭医生团队照护模式对城市社区失能老人的服务效果，从而为建立健全社区失能老人长期养老照料体系提供决策依据。方法：选取2019年1-12月北京市某社区≥60岁符合中重度失能评判标准的老年人170例，对其进行为期1年的健康干预，对比分析家庭医生团队管理对社区失能老人生活质量的影响因素，并对纳入研究的失能老人进行随访观察及访谈。结果：170例失能老人中，平均年龄(79.17±8.79)岁；144例患有高血压，占84.7%；89例患有糖尿病，占52.4%。失能老人在养老方式选择方面，希望居家养老的例数最多，占65.9%。养老服务需求最高的项目是定期提供心、肺等体格检查，占78.2%；失能老人在生活服务、护理服务、心理服务与社会支持方面均有不同程度的需求。干预后失能老人在躯体疼痛、精力、情感职能、精神健康方面及SF-36总分高于干预前，差异有统计学意义(P＜0.05)。通过定性访谈了解到，随着年龄的不断增长、生理功能不断退化，失能老人在生活上存在多方面的困难，大多数老年人担心对子女在照料方面的依赖会加重子女工作和生活上的负担，希望社区能够为高龄、失能老人提供上门医疗、康复护理、协助配药以及家务辅助等全方位的照护服务。结论：失能老人需要长期的医疗照护，开展家庭医生团队管理有助于提升城市社区中重度失能老人的生活质量，建议提升以失能老人服务需求为导向的家庭医生团队健康管理能力。

随着科学技术的发展以及民众对于健康需求的不断增加,各类医疗数据的收集和分析愈加精准,由此引发个体隐私权问题.针对医疗大数据的应用及发展现状,分析其中存在的问题,提出政府、医疗机构及科研人员在应对大数据、人工智能等新兴技术应用给医疗数据安全管理带来的挑战时,如何进行积极主动的风险管控;同时,结合当前针对医疗大数据研究中如何有效获得患者知情同意的问题进行探析,为相关领域科研项目的有序开展提供新的思路.

疫情防控中公共信息公开是体现政府公信力的关键砝码,疫情监测信息的及时、准确、全面公开彰显政府的责任与担当,确诊病例个体活动轨迹的信息公布有利于实现疫情的精准防范.而疫情处置中个人隐私信息保护则属于个体基本权益要求,应秉持"以人为本"的伦理原则,既要保障个体的生命安全,也要维护个体的人格尊严.公共信息公开应建立在个人隐私保护的基础之上,政府部门在进行公共卫生监测信息及时公开的同时,应加强对信息安全的有效监管,对于涉及个体隐私的信息必须进行妥善保护.鉴于疫情防控的应急之需,专业技术机构如疾病预防控制中心及医疗机构在特殊时期拥有获取个人信息的合法性以及对于个人隐私信息保护的强制性.基于利益分配的角度而言,疫情防控中公众知情权和个体隐私权的冲突与协调,其实质是公共利益和个人利益的制约与权衡.在疫情应对的特殊时期,政府及有关部门更需要妥善协调好个体利益和公共利益二者之间的张力,既不能以一昧牺牲个体利益来实现公共利益的最大化,也不能仅囿于个体利益而忽略公共利益的集体维护.在疫情应对中,出于公共利益的考虑而必须限制或干预某些个人权利时,应尽量做到对公民权利的侵犯限定在最小范围内,对个体权益的适当限制要符合公共利益集体维护的合理要求,应是鉴于当时情境下所必须采取的权宜之策.