基于医疗资源合理配置的医养结合型养老服务研究

发布时间：2018-01-05 06:13

本文关键词：基于医疗资源合理配置的医养结合型养老服务研究　出处：《武汉大学》2017年硕士论文　论文类型：学位论文

【摘要】：随着经济的发展和生活水平的提高,我国老龄化进程不断加快,高龄、失能、空巢老人不断增长,加之计划生育政策导致家庭养老功能弱化,我国老年人的养老和医疗需求日益增加。目前,我国的养老服务和医疗服务是两个相对独立的提供系统,老年人对养老和医疗的双重需求很难同时得到满足。因此,我国必须创新机构养老模式,整合医疗资源和养老资源。发展医养结合型养老模式是改革养老模式的必然趋势,也是应对人口老龄化问题的长久之计。本文在阐述医养结合内涵及相关理论的基础上,将养老市场中的四种医养结合模式按主导机构的不同归为两大类型,分别是以养老机构为主导的医养结合模式和以医疗机构为主导的医养结合模式。为了了解医养结合模式的现状,本文从两类模式中各选取一个典型机构进行个案分析,通过实地调研,对两个机构的政策支持、经营状况、软硬件环境、服务内容、入住老年人结构、费用等方面进行分析。其中重点对医养费用进行了比较分析,对于同等失能程度的老年人而言,两个机构的床位费、伙食费、护理费差异不大,而医疗机构的医疗费用相对较低,因此医院开办养老服务在费用上有一定优势。虽然医养结合受到了老年人的欢迎,但仍存在很多问题,包括资金不足、缺乏长期护理保险、人才短缺、"医闹"风险等,具备医养结合条件的养老机构为数不多,试水养老服务的医疗机构更是寥寥可数,难以满足老年人的医养需求。本文从医疗资源合理配置的考虑出发,认为在医疗资源紧缺的现状下,二级医疗机构开办养老服务相比于养老机构内设医务室的优势明显,既能节约老年人的医疗费用,又能合理配置医疗资源,是未来医养结合养老模式的一种发展趋势,有必要采取相关措施支持医疗机构开办养老,政策建议有四点:一是强化政府职责,加大政府支持力度;二是建立长期护理保险制度,颁布长期护理保险法;三是培养专业的医护人才,提高待遇水平;四是缓解医患关系。
[Abstract]:With the development of economy and the improvement of living standard, the aging process of our country is speeding up, the aging, the disability, the empty nest old people are increasing, and the family planning policy leads to the weakening of the family pension function. At present, the old-age service and medical service in our country are two relatively independent supply systems. It is difficult for the elderly to meet the dual needs of old-age care and medical care. Therefore, China must innovate the institutional pension model. The integration of medical resources and old-age resources and the development of a combination of medical care and support is the inevitable trend of reforming the old-age model. It is also a long-term solution to the aging of the population. Based on the elaboration of the connotation and related theories of the combination of medical and nursing, the four modes of combination of medical and nursing in the old-age care market are classified into two types according to the different leading institutions. In order to understand the current situation of the combination of medical and nursing, it is the mode of combination of medical care and support, which is dominated by pension institutions and medical institutions, respectively. This paper selects a typical institution from each of the two models for case analysis, through field research, the policy support of the two institutions, business conditions, hardware and software environment, service content, the structure of the elderly. For the elderly with the same degree of disability, the difference of bed fee, board cost and nursing fee between the two institutions is not significant. The medical cost of medical institutions is relatively low, so there is a certain advantage in the cost of providing old-age care services in hospitals. Although the combination of medical care and nursing is welcomed by the elderly, there are still many problems, including insufficient funds. Lack of long-term care insurance, talent shortage, "medical trouble" risk, with the combination of medical care and support of the few pension institutions, water pension services are very few medical institutions. It is difficult to meet the medical and nursing needs of the elderly. From the consideration of rational allocation of medical resources, this paper thinks that the medical resources are in short supply. Compared with the old-age care institutions, the second-level medical institutions have obvious advantages in setting up medical clinics, which can not only save the medical expenses of the elderly, but also reasonably allocate the medical resources. It is a kind of development trend of the future combination of medical care and raising for the aged, it is necessary to take relevant measures to support the medical institutions to set up old-age care, the policy suggestion has four points: first, strengthens the government duty, strengthens the government support dynamics; Second, establish long-term care insurance system, promulgate long-term care insurance law; Third, to train professional medical talents and improve the level of treatment; Fourth, ease the relationship between doctors and patients.
【学位授予单位】：武汉大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1;D669.6

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