“医疗嵌入型”医养结合服务的行为逻辑与实践经验——基于上海市六个区的调查分析

Behavioral logic and practical experience of “medical embeddedness” as elderly care with medical service:A study of six districts in Shanghai

医养结合服务是养老服务模式的一大创新,然"医疗嵌入型"服务的行为逻辑如何尚未得到深入研究。通过嵌入理论的视角,阐释医疗服务嵌入养老机构的知识获取效应、治理效应和共享效应。同时,基于上海市六个区的多方调查,考察"医疗嵌入型"医养结合服务的典型模式和实践经验,总结出当前医养结合服务尚存在内源型服务模式难以奏效、外源型服务模式流于形式、人才紧缺成为发展瓶颈、条块分割造成效率损失和政策衔接缺失诱发隐患等问题。为此,要优化服务模式的选择机制、建立医护人才培育的长效机制、制定适宜的养老服务行业标准与规范、建设省级统一的信息共享系统、出台配套的政策衔接办法。

＂Elderly care with medical service＂is an innovative model of the elderly care service,but the behavioral logic of＂medical embeddedness＂as elderly care with medical service has not been thoroughly studied. From the perspective of embeddedness theory,this paper discusses the knowledge acquisition effect,governance effect and shared effect of the institutions providing medical services embedded in the elderly care. At the same time,based on a multi-pronged survey of six districts in Shanghai,it has examined its typical models and experience,and analyzed such problems as the inefficiency of the endogenous and external service models,the bottleneck in development due to the shortage of talents,the inefficient operation due to the poor departmental cooperation as well as a lack of long-term policies. Thus,it is necessary to optimize its selection mechanism,establish a long-term mechanism for the training of medical personnel,formulate its appropriate standards and rules,build a shared information service system at the provincial level,and formulate appropriate policies.