According to the seventh national census, the number of elderly people aged 60 and above in my country has reached 264 million, accounting for 18.7% of the total population.
Compared with young and middle-aged people, the elderly have a high prevalence rate, a variety of diseases, and a long period of illness, and the demand for medical care services continues to increase.
A few days ago, the National Health and Health Commission, the National Development and Reform Commission, the Ministry of Education and other ten ministries and commissions issued the "Guiding Opinions on Further Promoting the Development of Integrated Medical Care" (hereinafter referred to as "Guiding Opinions") 15 specific measures have been put forward in 6 major areas, including medical and elderly care services, optimizing service connection, improving support policies, attracting and cultivating talents through multiple channels, and strengthening service supervision.
Then, can the "Guiding Opinions" further stimulate the enthusiasm of medical and elderly care practitioners, continuously improve the quality and efficiency of medical and elderly care services, and protect the "red sunset" of the elderly?
Regarding social concerns, the reporter interviewed experts in relevant fields.
Integrated services that integrate prevention, medical treatment, health care, nursing, health management, and health promotion
In the opinion of experts, the combination of medical care and elderly care goes beyond the traditional concept of elderly care that only emphasizes a single "nursing" service connotation, and pays more attention to the integration of elderly care services and medical services.
Ding Yuanzhu, a professor and doctoral supervisor of the Social and Ecological Civilization Teaching and Research Department of the Party School of the Central Committee of the Communist Party of China (National School of Administration), believes that the first part of the "Guiding Opinions" clearly proposes to develop home-community medical care services, actively provide home medical services, and enhance community medical care. Combined with service capabilities, it shows that the document is based on China's national conditions, and the work of combining home-community medical care and nursing care is placed in an important position.
The "Guiding Opinions" emphasizes health as the center, emphasizes the contract service of family doctors as the starting point, and highlights the comprehensiveness and continuity of the combination of medical care and health care by integrating the integrated services of prevention, medical treatment, health care, nursing, health management and health promotion. Serve.
On the basis of implementing the contracted services of family doctors for the elderly, steadily increase the coverage of family doctors contracted services for the elderly with disabilities, chronic diseases, advanced age, disabilities, etc.
As the first expert member of the National Committee on Aging, Ding Yuanzhu has always been concerned about promoting the combination of medical care and elderly care.
He pointed out that the demand for the combination of medical and elderly care is mainly at the grassroots level.
It is necessary to pay attention to the construction of informatization, and establish an information system for information collection, statistical analysis and service management of the health and pension status of the elderly.
It is suggested that all localities should classify and implement policies when implementing the combination of home and community medical care, and analyze and classify the existing family structure and family relationship with the community as a unit. What kind of method needs to be adopted, comprehensively consider the structure of each family, the status of children, the physical condition of the elderly and other categories to implement policies.
Optimized supporting policies related to price, insurance, taxation, land, etc.
According to the forecast of the China Population and Development Research Center, by 2025, there will be 221 million elderly people aged 65 and above in my country.
With the rapid development of population aging, the contradiction of insufficient resources of medical and elderly care services in my country will exist for a long time.
"The "Guiding Opinions" put forward practical solutions for some long-standing and difficult problems that have been difficult to solve for a long time, and optimized relevant supporting policies." Researcher of the National Institute of Development and Strategy of Renmin University of China, professor of the Institute of Gerontology Huang Shisong pointed out that, for example, in solving the problems of lack of enthusiasm for providing services in contracted public medical institutions, "there are contracts, but no services", focusing on solving the "last meter" institutional obstacles, which not only gives them pressure and motivation.
At the same time, the price policy has also been improved, and the method of "medical service price + door-to-door service fee" is adopted to improve the level of home-based medical services. Waiting for the medical staff with better service to tilt and so on.
Regarding social concerns about whether medical insurance can provide support for the combination of medical care and elderly care, the "Guiding Opinions" also clarifies that medical insurance support should be strengthened, and medical and health institutions within qualified elderly care institutions should be included in designated medical insurance management in a timely manner; The service items are included in the scope of medical insurance payment.
At the same time, explore the implementation of bed-day payment for diseases that require long-term hospitalization, such as inpatient palliative care and medical rehabilitation, and whose average daily cost is relatively stable; promote the pilot program of long-term care insurance system, encourage the development of commercial health insurance, and build a multi-channel financing mechanism. Improve the purchasing power of demanders and form a multi-level medical care security structure.
More than that, according to Ding Yuanzhu, the "Guiding Opinions" also put forward a series of support policies for the integration of medical and elderly care services, such as land, finance and taxation, and informatization, and proposed to promote "Internet + medical and health" through the implementation of community-based medical and elderly care integration capacity enhancement actions. "Internet + nursing service" and other means to develop home-community medical and nursing services.
Encourage ordinary colleges and vocational colleges to set up relevant majors and expand the scale of enrollment
Talent training is an important foundation for promoting the combination of medical care and nursing.
The "Guiding Opinions" encourages ordinary colleges and vocational colleges to set up related majors, expands the scale of enrollment, and further expands the training paths for talents that combine college training and institutional training by strengthening the training and training of relevant personnel.
"In terms of talent training, we should adhere to the combination of long-term and short-term. It not only proposes to support retired and rehired nurses with rich clinical experience to provide services in the front line, but also proposes measures to encourage colleges and universities to add health and pension-related majors and courses to consolidate sustainable development. foundation." Huang Shisong said.
Ding Yuanzhu also introduced that the integration of home and community medical care should also solve the problems of participation, tracking and innovation of professional and technical personnel.
At present, the early development of community service and governance data, information, and intelligent platforms is mainly completed by third parties. In the later use, maintenance and update, the grassroots face technical difficulties and other problems, including data collection, uploading, summarizing, and adapting to the new situation. project development, etc.
"This requires establishing advanced awareness in the top-level design and grass-roots operations of policies, and putting the training of professional and technical personnel at the bottom on the agenda. It is necessary to cultivate a group of grass-roots cadres who have professional knowledge, are familiar with the work of the elderly, and are familiar with social psychology."
Over the years, my country has successively carried out many pilot demonstrations in promoting the development of the cause of the elderly, and formed a policy implementation mechanism of "up and down linkage" characterized by "pilot first - popularization and application".
Huang Shisong said that when implementing the "Guiding Opinions", local governments can actively explore and innovate by taking pilot demonstrations as the starting point in light of the specific local conditions.
For example, encourage the branding, chaining, and large-scale development of medical and elderly care enterprises and market players; give play to the role of state-owned enterprises in revitalizing existing elderly care and medical service resources in the integration and reorganization, and provide a practical basis for formulating new policies at the national level .
In order to provide a combination of medical and elderly care services that reassures the people, the "Guiding Opinions" also emphasizes that the medical and health institutions in the elderly care institutions should be included in the scope of "double random, one public" supervision and random inspection of medical and health institutions, and the elderly care services provided by medical and health institutions should be included in the elderly care institutions. The scope of "double random, one open" supervision and random inspection of institutions will guide relevant institutions to continue to optimize the combination of medical care and elderly care services.
(Reporter Jin Zhenya of this newspaper, Beijing, July 21)