关键词: 家庭医生助理, 服务模式, 文献计量学, 人员配置, 服务内容, 绩效分配

Abstract: Background　During accelerating the implementation of family physician services，the efficiency of family physicians may be enhanced by the help from an allocated assistant，a role commonly referred to as family physician assistant. Community health centers in some regions of China，such as Shanghai and Beijing，have developed a healthcare delivery mode with family physicians as the core workforce and the main subject of liability，and nurses as major assistants. However，there is still a lack of uniform standard for the constituents of the core workforce of family physician teams，as well as the features，work scope and salary system of family physician assistants. Objective　To perform a sino-foreign comparative analysis of family physician assistants，providing a reference for the development of this occupational group in China. Methods　From November 5 to 20，2019，we searched the databases of PubMed，ScienceDirect，CNKI and WANFANG DATA for articles involving family physician assistants published between 2009 and 2019 using subject headings or key words such as "amily physician assistant" "general practitioner assistant" "全科医生助理" "家庭医生助理" or "家庭医生 and助理" or "全科医生and助理". Data about staffing allocation，features，major responsibilities and duties，performance assessment and performance-based remuneration allocation of family physician assistants were extracted and analyzed using bibliometric analysis，and were summarized. Results　By reviewing the full text，47（31 in English and 16 in Chinese） were found to be eligible. The role of family physician assistant mainly played by full-time physician assistant，nurse，public health physician，rural physician，and general practitioner assistant fostered by a "3+2" general practitioner training program. The difference is that，the position at abroad is held by those who have received pre-service physician assistant training，and obtained the practicing certification or academic credentials，but in China，the full-time position is held by mainly physician assistants of non-medical majors after receiving pre-service family physician assistant training，and the part-time positions，such as nurses，public health physician，and rural physician，are held by incumbent healthcare workers from the community health center. The responsibilities and duties of family physician assistants differ in different countries，but mainly include delivering therapies，health management，health education，triage，preliminary health assessment and chronic disease follow-up. The performance of the family physician assistant is commonly assessed by the healthcare institution using a uniform system，or assessed directly by the family physician at abroad，while in China，that is assessed by institutional uniform assessment，or a two-level assessment，namely，the quality of services included in the whole tasks of the community health center is assessed the quality-control department of the center using a uniform system，and the quality of family physician services is assessed the family physician. Conclusion　Great differences have been found between foreign countries and China in terms of occupational aptitudes，major responsibilities and duties，performance assessment and performance-based remuneration allocation of family physician assistants. In view of this，it is suggested to develop the family physician assistant team with general practitioners and nurses/rural physicians or general practitioners and full-time physician assistants as the core workforce，define the responsibilities and duties for family physician assistants multi-levelly，and formulate a remuneration allocation system based on three major indicators，complexity of medical techniques，and quality and quantity of services.

Key words: General practitioner assistant, Service mode, Literature review, Personnel allocation, Service content, Performance allocation