养老机构选址、规模及功能定位对医养结合模式选择的影响——基于扎根理论的探索性分析

The Influence of the Site Selection,Size and Functional Orientation of Nursing Organization for the Aged on the Adoption of Medical and Nursing Model:An Analysis of Grounded Theory

在扎根理论的指导下,课题组通过对不同城市的14家养老机构进行实地调研,采取半结构访谈的方式获取不同类型的养老机构在医养结合方面实践的第一手资料,并运用Nvivo11.0软件对资料进行分析。研究发现不同选址、规模及功能定位的养老机构对医养结合模式的偏好不同。因此,本文建议做强社区医疗;鼓励社区医疗与养老整合的制度创新;细化以养融医医保支付的项目清单;养老院+医院模式应将医院的诊疗模式转变为以慢病管理、健康数据管理为重点的医养融合模式。

A field survey of 14 nursing organization for the aged in different cities is conducted and the semi-structured interview provide a set of first-hand survey data in the guidance of grounded theory. The analysis of the data by Nvivo11.0 software finds that different siting, size and functional orientation of the institutions bring about different preferences to the adoption of medical and nursing model which should be the main police target for the elderly support social system in China. The following measures can be helpful to increasingly adoption of this new model： firstly, the government should strengthen the community medical cares; secondly, encourage the institutional innovation focus on the integration of community medical services and elderly support services; thirdly, enlarge the list of health insurance payments to cover more medical services of this model; finally, medical and nursing model means a shift from traditional hospital diagnosis and treatment to chronic disease management and health data management.