社区居家医养结合养老服务多中心治理模式研究——基于W市的实践

Research on the Polycentric Governance Model of Community-Home Care Center with Medical Care Services——Based on the Practice of W City

W市在发展“互联网+”社区居家养老服务、推进医养结合的实践中发现,基于多中心治理的社区居家医养结合养老服务在实际运行中偏离理想架构,出现了治理差距和治理偏差,主要表现在“单中心”治理格局独大、行政化色彩浓厚,以及各中心治理主体利益不同导致无法协同发力的局面。对此,要瞄准多元主体的实际定位,探索多中心治理的协同发展,同时也要推动“助医”服务体系、多层次长期照护体系、服务监管体系的进一步完善与发展。

In the practice of developing"Internet+"community home care service and promoting the combination of medicine and nursing,W City found that polycentric governance model of community-home care center with medical care services deviated from the ideal structure in actual operation,resulting in governance gap and governance deviation.It is mainly manifested in the situation that the governance pattern of"single center"is dominant,the administrative color is strong,and the different interests of each center governance subjects lead to the situation that they cannot work together.In this regard,this paper aims at the actual orientation of multiple subjects,explores the coordinated development of polycentric governance,and promotes the further development of"medical assistance"services,multi-level long-term care system,and service supervision system.