Zhongguo quanke yixue (Dec 2022)
Research Hotspots and Trends of General Practice and Community Health in China: Based on the Data of Chinese Journals in General Practice from 2001 to 2020
Abstract
Background To meet the growing healthcare needs of people and requirements of the national healthcare reform, general practice and its service delivery models have been introduced into Chinese mainland, and developed rapidly with the support and promotion of national policies. However, the localization of general practice in China has revealed that the academic discipline development and delivery models of general practice are still immature, and the research content, practice path and research methods regarding general practice need to be further clarified. Objective To perform a review of the articles published in Chinese general practice journals to assess the academic discipline development, theoretic research and practice status, and focus areas for development regarding general practice, providing evidence for academic discipline development of general medicine in China. Methods In December 2021, the CNKI database was systematically searched for articles published in four representative Chinese general practice journals (Chinese General Practice, Chinese Journal of General Practitioners, Chinese Journal of General Practice, and Chinese Primary Health Care) from 2001 to 2020, and the official websites of the State Council and the National Health Commission of the People's Republic of China were searched for policy documents about general practice and the reform of the pharmaceutical and healthcare system issued from 1997 to 2020. The themes of policy documents in every five years in the period 2001—2020 were analyzed. And keywords of articles published in every five years in the period 2001—2020 were extracted for word frequency analysis and co-occurrence analysis, and for identification of the burst terms. Then the consistency of research hotspots with the themes of policy documents in every five years during 2001—2020 was assessed. Results Altogether, 54 726 articles were included, from which 1 398 keywords were extracted and sorted out, and 62 related policy documents were retrieved. The top 10 keywords in terms of frequency of use were "efficacy" (n=2 998) , "community health service" (n=2 235) , "diabetes" (n=2 004) , "influencing factors" (n=1 586) , "elderly people" (n=1 368) , "diagnosis" (n=1 359) , "hypertension" (n=1 313) , "general practitioner" (n=1 303) , "children" (n=1 302) and "nursing" (n=1 107) . By cluster analysis of key words, the major directions of research on general practice and community health during 2001—2020 were classified into three categories: clinical diagnosis and treatment (involving the efficacy assessment of treatment, nursing, and various laboratory examination methods, and diagnosis and treatment of multiple cancers) , disease management (including the management of various common diseases and frequently-occurring diseases, and most of them are chronic diseases, such as diabetes, hypertension, chronic obstructive pulmonary disease, coronary heart disease, depression, pregnancy complications, and cognitive dysfunction) , and community health services (mainly involving health education, community health, rural health, contracted family doctor services, tiered diagnosis and treatment, and bi-directional referral services) . The analysis of burst terms indicated that the focus of research during 2001—2005 was mainly on clinical analysis and clinical observation of diseases, community health services, township health centers, and rural doctors, and that during 2016—2020 was mainly on the analysis of influencing factors of diseases, tiered diagnosis and treatment, contracted family doctor services and quality of life, which were basically consistent with the requirements of the national policies regarding medical and health development. Conclusion The research regarding general practice and community health from 2001 to 2020 in China revealed that general medical services have played an important part in satisfying the needs of basic medical and public health, which cover all population throughout the entire lifecycle, and focus on addressing both somatic or mental health issues. Moreover, the related research hotspots were centered on the application of the biopsychosocial model and people-centered model, and basically targeting the requirements of the national reform of the pharmaceutical and healthcare system. It is recommended to paid more attention to general practice education and the innovation of medical models in future research, so as to promote the sustainable development of general practice.
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