社区医养结合服务包构建的问题与对策——基于上海市普陀区的实证研究

Empirical Analysis on the Problems and Strategies of Integrating Pension Service with Medical Service Package Construction in Community:A Case Study of Putuo District of Shanghai

目的了解分析上海市普陀区社区医养结合服务包构建现况及存在的问题,提出相应的对策。方法于2018年4月选取上海市普陀区四类典型的社区医养结合服务模式的试点单位,对各类模式拟实现的效应目标、服务对象和服务方案等进行实地调研。结果四类医养结合服务模式都定位于满足老年人的基本医疗和公共卫生服务需求,主要是面向居家和养老院的老年人提供一些医疗和公共卫生服务。全科团队是服务的主要提供方,部分模式还涉及第三方机构。结论目前社区医养结合服务包与老年照护统一需求评估结果还不完全匹配,且服务包也缺少相应的开发质控。政府和社区卫生服务中心还需要发挥资源整合能力,构建有针对性的、服务利用率高的社区医养结合服务包。

OBJECTIVE To understand and analyze the current situation and existing problems of the integrating pension service with medi cal service package construction in Putuo District of Shanghai,so as to provide the propose corresponding countermeasures. METHODS 4 pilot units of integrating pension service with medical service were selected as research objects in April 2018,which each represented a typical mode. The survey content included the effect targets,service objects,service plans and so on. RESULTS The effect targets for 4 types of“integrating pension service with medical service”mode,were all positioned in meeting the needs of the elderly for basic medi cal services and public health services. The service objects were mainly related to the elderly in homes and nursing homes. The service content mainly involved some medical services and public health services. The general team was the main provider of services and some modes involved third-party service units. CONCLUSION There was a lack of correlation between the community integrating pension ser vice with medical service and the results of the unified needs assessment for elderly care,and the service package also lacked the quality control in mode development. The cost of services was also out of control. In this regard,the government and the community health cen ters needed to actively play the role of resource integration,and develop package with target and high utilization based on the health of de mand-side parties.