Recently, with the approval of the State Council, 11 departments including the National Health and Health Commission jointly issued the "Guiding Opinions on Further Promoting the Development of the Integration of Medical Care and Nursing Care" (hereinafter referred to as the "Opinions"), which provides important guidelines for promoting the high-quality development of the combination of medical care and nursing care.
During the "14th Five-Year Plan" period, my country's population aging has further deepened.
By the end of 2021, my country's population aged 65 and over accounted for 14.2% of the total population.
According to the China Population and Development Research Center, by 2025, the population of people aged 65 and above will reach 221 million.
Promoting the combination of medical care and elderly care is an important measure to optimize the supply of elderly health and elderly care services.
In recent years, my country's policy of combining medical care and elderly care has been continuously improved and positive progress has been made, but there are still some shortcomings in policy support, service capabilities, and talent development.
How to solve the difficulties and blockages in the integration of medical care and health care?
The reporter interviewed some experts and scholars.
Develop home-community medical and nursing services
The "Opinions" require the development of home-community combined medical and nursing services.
One is to actively provide home medical services.
For example, support qualified medical and health institutions to provide home medical services such as home hospital beds and door-to-door visits for elderly people with disabilities (dementia), chronic diseases, advanced age, disabilities, etc. "Internet + Nursing Services", providing convenient home medical services for the elderly in need.
The second is to enhance the ability of community medical and elderly care services.
For example, the implementation of the community health care integration capacity improvement action, the qualified community health service institutions, township health centers and other institutions use existing resources to internally renovate and expand a number of community (township) health care integration service facilities.
Liang Wannian, executive deputy dean of the Vanke School of Public Health and Health at Tsinghua University, believes that with the aging of the population comes the increase in the health and care needs of the elderly.
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.
The "Opinions" further improve the policy system, service system, standard system, talent system, and information system of the combination of medical care and elderly care in my country. institutional environment.
Feng Wenmeng, a researcher at the Development Research Center of the State Council, believes that the "Opinions" are based on summarizing the experience of my country's rapidly advancing medical and elderly care integration pilots in recent years. The combination of nourishment and high-quality development has laid a solid institutional foundation.
Ding Yuanzhu, a professor at 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 Governance), believes that the "Opinions" are based on my country's actual situation and put the combination of home and community medical care in an important position, which meets the needs of my country's elderly health care services.
The organic combination of home-based care and community care, and the organic integration of care and medical services, as well as the development of an integrated family and community medical care service construction on this basis, on the one hand, enables the elderly to communicate with their families, Neighborhood exchanges and blends; on the other hand, incorporating medical security into the family community pension service system can enable the elderly to receive timely and effective medical services.
Promote institutions to carry out integrated medical and elderly care services
The "Opinions" pointed out that institutions should be encouraged to carry out in-depth medical and elderly care services.
The first is to support medical and health institutions to carry out medical and elderly care services.
For example, promote medical and health institutions to expand on-site medical services to elderly care institutions, and provide services such as home hospital beds and door-to-door inspections for eligible elderly people living in elderly care institutions.
The second is to improve the service capabilities of the elderly care institutions in combination with medical care and elderly care.
For example, support elderly care institutions and medical and health institutions to carry out contractual cooperation, and provide elderly care institutions with services such as green channels for appointments for medical treatment and door-to-door inspections.
Huang Shisong, a researcher at the National Institute of Development and Strategy of Renmin University of China and a professor at the Institute of Gerontology, believes that achieving high-quality development of the combination of medical care and elderly care requires efforts in many aspects. The advantage of its flexible mechanism is to expand the supply of incremental resources for the combination of medical and elderly care services; it is also necessary to loosen the constraints on public medical and health institutions, fully mobilize the enthusiasm of public medical and health institutions and medical personnel, enhance development momentum and vitality, and revitalize the stock resources of the combination of medical and elderly care. .
Hao Xiaoning, a researcher at the Health Security Research Department of the Health Development Research Center of the National Health Commission, pointed out that family doctors are an important basis for medical and health institutions to set up family beds and carry out home medical services.
The "Opinions" propose that, on the basis of implementing the contracted services of family doctors for the elderly, the coverage rate of contracted family doctors for elderly people with disabilities (dementia), chronic diseases, advanced age, disabilities, etc.
On the basis of basic public health services, and based on the differentiated health needs of the elderly, all regions can design personalized family doctor contracted service packages to further improve the coverage of the elderly family doctor contracted services and improve the accessibility and acquisition of home medical services for the elderly. sense.
Encourage medical and health institutions to provide medical support for elderly care institutions to carry out medical and elderly care services to meet the needs of elderly people living in institutions. Serve.
Improve support policies and strengthen talent introduction and cultivation
The "Opinions" pointed out that the price policy should be improved, insurance support should be increased, land resources should be revitalized, and fiscal and tax incentives should be implemented.
For example, public medical and health institutions provide door-to-door medical services for the elderly and other groups, and adopt the method of "medical service price + door-to-door service fee"; timely include qualified medical and health institutions in old-age care institutions into designated medical insurance management; medical and health land . Social welfare land can be used for the construction of medical and elderly care projects; implement relevant preferential tax policies to support social forces to provide multi-level and diversified medical and elderly care services.
Chen Gong, director of the Population Research Institute of Peking University, believes that the "Opinions" highlight three highlights: systemic, continuous and sustainable, improve the multi-dimensional support system for the combination of medical care and elderly care, strengthen the continuity of medical and elderly care services, and ensure the integration of medical care and elderly care. Service Sustainability.
The "Opinions" further expand the service objects, service providers and supply fields included in the integrated medical and nursing system, laying a foundation for my country to build a continuous "medical-nursing-nursing" service framework to meet the changing medical needs of the elderly. and long-term care needs.
Essentially, the health status of the elderly is relatively fragile during the care gap period, and the “medical-nursing-nursing” continuous service system fills the gap between medical care and long-term care for the elderly.
The "Opinions" proposed to introduce and cultivate talents through multiple channels, strengthen personnel training and training, and guide medical personnel to engage in combined medical and nursing services.
For example, accelerate the training of talents in shortage in medical and health care and elderly care services, and include medical talents such as geriatric medicine, nursing, rehabilitation, and general practice, as well as elderly care workers, nursing home directors, elderly social workers and other elderly care service and management talents into relevant training programs; The total amount of performance-based wages shall be reasonably approved according to the situation of the combination of medical and elderly care services carried out by public medical and health institutions.
Hao Xiaoning believes that the "Opinions" put forward a package of measures to strengthen the team of family doctors and other medical and nursing talents, so as to create a better environment to support the sustainable development of the combination of medical and nursing. Preference will be given to medical staff who have completed home medical services, medical and nursing services and other services with better services.
All localities should, in light of their actual work, encourage the active exploration of various medical personnel such as retired medical personnel and physicians in secondary and tertiary hospitals, enrich the team of family physicians, and strengthen the capability of family physicians through standardized training of geriatric medicine specialists for family physicians. building.
Our reporter Bai Jianfeng