养老机构医养结合养老服务模式研究

发布时间：2018-05-27 14:12

本文选题：养老机构 + 医养结合　；参考：《东北财经大学》2016年硕士论文

【摘要】：我国的人口老龄化是在"未富先老"、城乡和区域发展不均衡、社会保障制度不完善等背景下到来的,如何解决庞大规模的老年人口养老问题,是目前社会关注的焦点。为了改变我国目前的养老现状,实现老年人"老有所医、老有所养"的目标,就必须重新审视当前养老机构的"医养分离"的服务模式。中国现行的民政部门负责解决养老服务、医疗机构提供门诊和短期住院服务的结果,导致了老年人养老中的医疗和长期护理的供求矛盾。"医养结合"养老服务模式是在老龄化背景下,解决中国老年人养老和医疗问题的有效路径,尤其对于那些失去自理能力的老年人及其家庭而言,这种服务模式可以较大程度地解除他们的后顾之忧。本文通过对概念的重新理解,进一步明确了医养结合养老服务模式的内涵,认为,医养模式涉及服务对象、服务内容、服务提供主体、服务模式的实现、服务人员以及服务机构的资质和准入标准等,并探讨了医养结合服务模式的实现方式。论文在研究"医养结合"养老模式发展现状基础上,分析了当前"医养结合"养老模式发展存在的问题,这些问题包括:政府多头管理,政策扶持落实难;资金投入不足,服务主体参与积极性不高;医保定点覆盖率低;缺乏老年医疗护理专业人才等。"医养结合"养老模式是实践"医养结合"理念,实现医疗资源与养老资源结合,达到资源优化配置的方法或手段。论文将"医养结合"养老服务模式分为内置型"医养结合"养老服务模式、联动型"医养结合"养老服务模式和辐射型"医养结合"养老服务模式。其中,内置型"医养结合"养老服务模式又分为养老机构内置医疗机构和医疗机构内置养老机构;联动型"医养结合"养老服务模式又分为专业型养老机构+医疗机构和复合型养老机构+医疗机构,并借助典型案例对每种模式进行了分析,探讨了中国养老机构医养结合养老服务模式的发展趋势。针对我国养老机构在"医养结合"养老服务模式发展中存在的问题,本文提出了一系列对策建议:一是强化政府职责,发挥政府主导作用,加强多部门合作协同推进医养结合发展;二是重视相关法律体系建设,完善落实医养结合优惠扶持政策;三是逐步建立长期护理保险制度,改革医疗保险结算制度,创新医疗报销机制;四是通过增设老年养护服务相关专业及课程和重视在职护理人员的专业技能培训,建立合理薪酬和福利待遇来加强照护队伍的专业化建设;五是建立健全监督评估体系,加强对医养结合工作的绩效考核和日常监督,适时开展工作检查,及时发现问题,采取有效措施予以改进,确保医养结合工作落实到位。本文的创新之处在于将医养结合组合形式按照提供主体进行了分类,并结合相关的典型案例,研究了每种医养结合养老服务模式的优缺点及适用范围,有助于不同类型养老机构医养结合服务模式的目标定位的明确化和管理的规范化。
[Abstract]:The population aging in China is coming from the background of "not getting rich before the old", the uneven development of urban and rural and regional development, the imperfect social security system, and so on. How to solve the large scale of the elderly population pension problem is the focus of social concern at present. In order to change the present situation of the old age of our country and realize the goal of the old people "have a good medical care and be old." It is necessary to reexamine the service mode of "separation of medical care" in the current pension institutions. The current civil administration department in China is responsible for solving the old-age service. The medical institutions provide the results of outpatient and short-term hospitalization services, which leads to the supply and demand of medical care and long-term care in the elderly. In view of the effective way to solve the elderly and medical problems of the elderly in China, especially for the elderly and their families who have lost their self-care ability, this service model can greatly relieve their worries. This article further clarifies the connotation of the mode of medical care and pension service through the re understanding of the concept. The mode of medical care involves the object of service, the content of service, the main body of service, the realization of the service mode, the qualification and the admittance standard of the service personnel and the service organization, and the realization mode of the mode of medical care integration service. The problems exist in the development of the model, such as the management of the government, the difficulty of policy support and implementation, the lack of funds, the low participation of the main body of service, the low coverage of medical insurance, the lack of medical care professionals for the elderly, and the lack of medical care professionals for the elderly. According to the method or means to achieve the optimal allocation of resources, the paper divides the "medical care combination" old-age service mode into a built-in "medical care combination" old-age service mode, a coordinated "medical care combination" old-age service model and a radiative "medical support combination" old-age service mode. The medical institutions and medical institutions have built in the old-age institutions built in, and the linkage type "medical care combination" old-age service mode is divided into professional old-age institutions + medical institutions and compound old-age institutions + medical institutions, and with the aid of typical cases, each model is analyzed, and the development trend of the Chinese pension system for the pension service mode is discussed. A series of countermeasures and suggestions are put forward in this paper: first, to strengthen the government's responsibility, to play the leading role of the government, to strengthen cooperation in multi departments and to promote the combination of medical care and support; two, to attach importance to the construction of relevant legal systems and to improve the preferential policies for the implementation of the combination of medical and medical care; Three is to gradually establish long-term care insurance system, reform the medical insurance settlement system, innovate medical reimbursement mechanism, four is to strengthen the professional skills training of the elderly maintenance services related majors and courses, and pay attention to the professional skills training of in-service nursing staff, establish reasonable salary and welfare treatment to strengthen the professional construction of the care team; five is to establish and improve the supervision. The system of supervision and evaluation should strengthen the performance assessment and daily supervision of the combination of medical and maintenance work, timely carry out the work inspection, find the problems in time, take effective measures to improve it, and ensure the implementation of the combination of medical and maintenance. This case studies the advantages and disadvantages of each kind of medical care and pension service mode and the scope of application, which helps to clarify the target orientation and standardize the management of the combination service model of different types of pension institutions.
【学位授予单位】：东北财经大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：D669.6

【引证文献】