社区卫生服务中心参与医养结合服务现状研究

Research on the status quo of the community health service center participation in the integration of elderly care and medical services

目的:分析社区卫生服务中心通过不同方式参与医养结合服务的主要做法,为社区卫生服务中心参与医养结合服务提供建议。方法:采取目的抽样法,在东、中、西部各选取开展医养结合服务且具有代表性的上海市、武汉市、重庆市共6家社区卫生服务中心进行现场调查。运用主题框架分析法对资料进行分析。结果:调研地区社区卫生服务中心参与医养结合服务主要包括社区卫生服务中心参与居家养老、社区养老、养老机构养老以及社区卫生服务中心提供养老服务等。每个调研地区社区卫生服务中心参与不同种类医养结合服务的服务对象、主体、方式和内容均有所不同。目前社区卫生服务中心参与医养结合尚缺乏统一的行业标准,部门间仍需要进一步协同,社区卫生服务中心参与医养结合服务的程度有限。结论:顶层设计需要考虑到社区卫生服务中心辖区居民的需求以及机构服务能力,制定老年人统一照护需求评估标准,确定社区卫生服务中心提供服务的内容与对象,同时加强信息化建设,提高社区卫生服务中心的服务效率。

Objective: This paper analyzes the way community health centers participate in the integration of elderly care and medical services, in order to provide suggestions for further development. Methods: Purposive sampling is used in this study. Six community health service centers which have participated in the integration of elderly care and medical services typically in Shanghai, Wuhan and Chongqing were selected as the field survey sites. Thematic framework analysis is then used to collect and analyze the data. Results: Community health service centers integrate elderly care and medical services by participating in home-based elderly care, community-based elderly care, institution-based elderly care, and providing elderly care at the centers. Service objects, service providers, service modes and service contents are different in each city. There are no unified service standards of the community health service centers participating in elderly care, and community health service centers are not able to provide more service related to elderly care. Thus, coordination among departments needs to be further strengthened. Conclusions: Local governments should make top-level policy design by considering the need of residents as well as the service capacity of their community health service centers, and make unified standard for elderly care needs assessment. Community health centers should also strengthen their service capacity by using information technology to increase their efficiency.