基于扎根理论的社区医养结合服务开展限制因素分析——以南宁市为例

Analysis of the Limiting Factors for the Development of Community Health Care Integration Services based on the Grounded Theory——Taking Nanning City as an Example

目的:分析社区医养结合服务发展的制约因素,为各地发展医养结合服务提供参考。方法:使用扎根理论分析法,对政府工作人员及社区医养结合服务机构工作人员进行半结构化访谈,借助Nvivov12.0质性分析软件,对访谈记录进行分析。结果:社区医养结合服务开展的限制因素包括政府、服务机构、专业人才、服务对象四个主范畴。政府范畴包括权责不清、保险覆盖面不全、财政倾斜不合理等;服务机构范畴包括收费标准不明晰、服务场地受限、缺乏经验、技术支撑不足、硬件设施不足等;专业人才范畴包括执业环境不佳、人才激励力度不足、人才培训短缺等;服务对象范畴包括不良传统思维禁锢。结论:社区医养结合服务发展的制约因素相互影响,共同作用,阻碍了社区医养结合的发展,应出台针对性措施,政府、机构、社会共同努力,促进我国社区医养结合服务发展。

Objective To analyze the constraints on the development of integrated community health care services and provide reference for integrated health care services in different regions. Methods Semi-structured interviews were conducted with government staff and staff of community health care integration services using the grounded theory analysis method, and the interview transcripts were analyzed by Nvivov 12.0,which is a qualitative analysis software. Results The constraints to the development of integrated community health care services included four main categories: government, service providers, professionals and service users. The scope of government includes unclear authority and responsibility, incomplete insurance coverage and unreasonable financial inclination. The scope of service institutions includes unclear fee standards, restricted service venues, lack of experience, insufficient technical support and inadequate hardware facilities. The scope of professionals includes poor practice environment, insufficient talent incentives and shortage of talent training. The scope of service recipients includes bad traditional thinking confinement. Conclusion The constraints to the development of community health care integration services interact and work together to hinder the development of community health care integration. Targeted measures should be introduced, and the government, institutions and society should work together to promote the development of community health care integration services in China.