解构与重塑:中国健康老龄化服务体系的探讨

Deconstructing and Reinventing:A Discussion of China’s Healthy Aging Service System

健康老龄化的理论已经提出了四十余年,然而健康老龄化理论的实现机制仍然不够清晰,理论与实践的衔接仍然存在明显的断点,对老年健康的干预现状十分有限。为此,文章聚焦于中国健康老龄化服务体系的建设进程,旨在通过理论诠释和实践反馈,探索健康老龄化理论的分歧,并构建我国的健康老龄化服务体系,探讨体系内不同主体的功能定位、服务内容以及在生命历程中的转化路径。研究认为,健康老龄化服务体系是公共卫生举措中卫生服务和长期照护服务的具象,其出发点和落脚点应该是老年人的内在能力和功能发挥。为实现对二者的维护,需要重新组织服务主体,梳理功能定位,对现有服务进行微观和宏观整合。文章结合我国实际情况,分别讨论了家庭、医疗卫生机构和社区三个主体的功能定位以及相关服务;基于生命历程的视角描绘了各个主体如何在老年人内在能力的不同阶段实现服务的供给和功能的阶段性转化,并阐述功能定位在主体联结中的重要作用。文中构建的健康老龄化服务体系适用于我国国情,具有实践性和可行性,可以为老年人提供安全、可及、高质、高效的服务,一定程度上弥补了健康老龄化从理论到实践的断点。

The theory of healthy aging has been introduced for forty years,yet the practice mechanism of healthy ag-ing is still not clear.Meanwhile,there are obvious gap between theory and practice,which have limited interventions on elderly health.This article focuses on the construction of healthy aging service system to explore the divergence of theory through theoretical interpretation and practical feedback.Subsequently,we envisioned a healthy aging service system that incorporates China’s nation context.More details about service subjects,such as functional positioning,service contents and transformation paths in life course were discussed in this part.This article argues that the healthy aging service system is a figuration of health services and long-term care system in public health initiatives.The start-ing and ending points should be the intrinsic capacity and functional ability of the older adults.In order to maintain them,it is necessary to reorganize service subjects,sort out its functional positioning,and integrate existing micro and macro services in current system.We discussed three related service subjects including family,medical and health in-stitutions and community,respectively.And depicted how these subjects realize the supply of service and the transfor-mation in different stages of older adults’intrinsic capacity.Finally,we delineated the importance role of subject’s function positioning in linking others.The healthy aging service system envisioned in this article is practical and feasi-ble and applicable to China’s national context.The system can provide safe,accessible,high quality and efficient ser-vices for older adults that can bridge the gap from theory to practice of healthy aging.