What is the integrated eldercare services with medical care, and how to do it

1. What is the "integrated eldercare services with medical care"?

The integrated eldercare services with medical care is a new type of eldercare mode that has gradually emerged in various places in recent years. Because it effectively combines modern medical service technology with the eldercare security mode, and realizes the innovation of the eldercare security mode of "treating with disease and recuperation without disease", it has become a hot issue of common concern to government decision-making departments and scholars.

 

The integrated eldercare services with medical care has the following basic characteristics:

From the perspective of security purpose, like the traditional eldercare mode, the integrated eldercare services with medical care aims to provide elderly life services for the elderly, so that the elderly can live in peace in their old age;

From the perspective of participants, it combines traditional eldercare institutions and medical care institutions, aiming to provide a new type of eldercare service for the elderly through diversified participants;

From the perspective of service content, "medicine" refers to the treatment of diseases, and "nursing" refers to a kind of maintenance and rehabilitation provided to patients with chronic diseases, especially the elderly with chronic diseases.

From the perspective of security objects, it is especially suitable for disabled and semi disabled elderly who cannot be well cared for in the traditional eldercare mode, such as patients in the rehabilitation period of major diseases, patients with chronic diseases, and patients with recurrent diseases;

From the perspective of human nature, it takes into account the elderly's eldercare needs and medical care needs at the same time, and are in line with the basic living needs of the modern elderly for "medical and nursing needs"

If defined in a broad sense, the integrated eldercare services with medical care is not only a new type of eldercare exploration that organically combines traditional eldercare security and modern medical care, but also means a leapfrogging and new concept of eldercare.

All the practice of providing eldercare service that combines medical service with eldercare service can be defined as the category of integrated eldercare services with medical care. Therefore, the integrated eldercare services with medical care can be understood as "the fusion of medical care and nursing care". That is to say, it goes beyond the single eldercare service in the traditional eldercare concept, and pays more attention to the possibility of obtaining eldercare and medical care at the same time, and pay attention to the combination of "nursing" and "medical care" in the elderly life security needs, so as to meet the multiple needs of the elderly, disabled, empty nested, sick and other people in the future.

 

2. What is the difference between the integrated eldercare services with medical care and the traditional mode

Firstly, compared with the traditional mode, there are obvious differences between the two in the content of services provided. On the basis of providing services including traditional eldercare mode and traditional medical care mode, the mode of integrated eldercare services with medical care provides specialized medical care and rehabilitation services for patients and the elderly, realizing the combination of traditional eldercare service and modern medical care service.

Secondly, different from the traditional mode which has a clear responsibility subject, the mode of integrated eldercare services with medical care has no clear responsibility subject. In specific practice, the integrated eldercare services with medical care can be carried out in medical institutions with geriatric departments, medical institutions providing disease treatment and rehabilitation treatment, and even nursing homes and welfare homes.

Therefore, the integrated eldercare services with medical care does not exist as an independent mode, but in a more sense, operates as a new mode of providing eldercare, medical care and rehabilitation services.

 

3. Advantages of eldercare institutions providing the integrated eldercare services with medical care

For a long time, China's nursing homes can only provide elderly care services without providing medical care, while hospitals only provide medical care without providing elderly care services. As a result of the separation of medical care and nursing care, the elderly in the nursing homes often have to go between the nursing homes and hospitals, which not only makes the elderly unable to receive timely treatment, but also creates a great burden on their families and society. On the other hand, the inability of nursing homes to provide professional rehabilitation care services has also caused many elderly to take the hospital as a "nursing home". Even when the disease is cured, the elderly still occupy the beds and do not leave the hospital, forming a phenomenon of serious "bed occupancy". In this way, the hospital's medical resources can not bring great benefits.

Through the establishment of medical care-nursing alliance between medical care institutions and eldercare institutions, the state of resource separation between elderly care institutions and hospitals is broken, and a win-win or even multi win situation can be formed: eldercare institutions can integrate the medical resources of the hospital to improve the ability to serve the elderly, and hospitals can establish a public welfare image, expand their own influence and the coverage of medical services; the elderly's access to medical and elderly care services can be realized, which can reduce the mental pressure and economic burden of the elderly's relatives and children

 

2. What are the modes of the integrated eldercare services with medical care in China?

At present, many areas in China have also made some explorations in the integrated eldercare services with medical care, and there are mainly four modes.

Mode 1: the medical resources of community hospitals will be radiated to nursing homes. For example, Shanghai has implemented the general practitioner mode in the central downtown area, which radiates the medical resources of community hospitals to the nursing homes within its jurisdiction through the patrol system and the signing of agreements, and realizes the rational utilization of medical resources through the ladder medical insurance reimbursement ratio.

Mode 2: a "small team" composed of several doctors and nurses assigned from public hospitals is stationed in nursing homes for a long time. This mode generally only exists in public eldercare institutions.

Mode 3: eldercare institutions invest in their own hospitals, which shall be operated by a professional medical team.

Mode 4: the hospital team directly operates the nursing home. Some existing eldercare centers are already public eldercare institutions with hospital investment and management. The nursing home with more than 500 beds is served by the hospital's professional nursing team. In addition to its advantages in medical rehabilitation and chronic disease prevention, it also provides personalized services such as dental filling and physical examination.

 

3. What are the difficulties in implementing the integrated eldercare services with medical care?

The prominent "aging" phenomenon, the severe aging situation of the population structure, the weakened "4-2-1" family structure eldercare function, and the seriously insufficient supply of eldercare services... the unique population, economy, society, management system and other multiple contradictions have led to multiple problems in the development practice of the eldercare mode of integrated eldercare services with medical care.

Therefore, relevant departments should strengthen cooperation, coordinate to formulate corresponding supporting policies, establish unified and perfect standards for eldercare and medical care services, standardize medical care behaviors, and ensure the eldercare and medical care needs of the elderly. The government should play a role in implementing supporting policies such as health access, civil affairs support and medical insurance fixed-point for the eldercare institutions integrating eldercare services with medical care. The health department should approve the elderly care institutions integrating eldercare services with medical care to become medical qualified institutions, and the civil affairs department should confirm their non-profit nature and include them in medical insurance. This not only solves the medical and nursing problems of the elderly, but also reduces the economic burden and mental pressure of the elderly and their families. At the same time, it can promote the improvement of the nursing level of the eldercare industry and the development of the elderly medical rehabilitation industry.

Fourth, define the grade evaluation criteria for the disabled and semi disabled elderly, and realize the full coverage of the elderly's health files. At present, some areas, including Shanghai and Guangzhou, have begun to locally formulate operable nursing grade evaluation system for the elderly.

Fifth, eldercare services for the disabled should be included in the social security management system. At present, some provinces and cities have taken the lead in implementing the long-term medical care insurance system, through which, the relevant medical care expenses incurred to the disabled elderly who meet the insurance conditions can be paid by the nursing insurance fund. Therefore, it is the general trend that eldercare services for the disabled are included in the social insurance management system. In this way, the economic burden of the disabled elderly can be greatly alleviated, the allocation of medical care and eldercare resources can be further optimized, and the use efficiency of social security funds can be improved.

Sixth, strengthen the professional construction of the nursing team. There are many difficulties in the exploration of the eldercare mode of integrated eldercare services with medical care, and the lack of professionals engaged in medical care for the elderly has become a common problem faced by eldercare and medical care institutions. Professional medical care services are the guarantee for the elderly to obtain high quality of life in their later years. At present, the training of professional nursing personnel has not gotten enough attention. As the training of professionals has a time cycle, if the planning can not start right now, then even with sufficient capital investment and sound legal protection, the shortage of human resources will still make the health and eldercare cause be a leaky bucket. The integrated eldercare services with medical care is a specialized special service, and it is imperative to carry out multi-level eldercare education.