摘要
目的:基于112份国家级政策文件了解居家养老医养结合的政策保障体系建设情况并给出优化建议。方法:运用彩虹模型构建居家养老医养结合政策保障体系的政策工具分析框架,确定政策工具在不同维度的分布特征以及对合作关系的保障力度;结合文本分析和聚类分析揭示居家养老医养结合政策保障体系的内容特征。结果:政策工具在不同保障维度的分布频率由高到低依次为服务维度(29.63%)、系统维度(27.52%)、功能维度(16.93%)、规范维度(11.64%)、专业维度(8.99%)和组织维度(5.29%);供给型、环境型和需求型政策工具占比依次为57.14%、35.45%和7.41%;从国家级政策文件中识别出14个高频关键词,聚为四类,与居家养老医养结合最密切的关键词是社区、民政部和护理。结论:居家养老医养结合的政策保障体系存在明显的结构性不均衡,需求型政策工具有待补充,多维度合作关系的保障有待局部调整;居家养老医养结合的建设目标、建设主体及内容都比较清晰,但需要进一步提升建设目标与内容一致性、强化中医药在居家养老医养结合的作用和细化居家养老医养结合的政策保障体系。
Objective To explore the construction of the policy guarantee system in the field of integrated health care and social services(IHSS)for in-home seniors,and provide the suggestion of improvement.Methods The Rainbow Model was used to construct the policy tool analysis framework of the policy guarantee system,and explore the distribution characteristics of policy tools in different dimensions and their guarantee on cooperation.Text analysis and cluster analysis were used to explore the policy content characteristics of the policy guarantee system of IHSS for in-home seniors.Results The distribution frequency of policy tools in different levels were ranked as service dimension(29.63%),system dimension(27.52%),functional dimension(16.93%),normative dimension(11.64%),professional dimension(8.99%)and organizational dimension(5.29%).The proportion of supply-oriented policy tools,environment-oriented policy tools and demand-oriented policy tools was 57.14%,35.45%and 7.41%,respectively.Based on the related national policy documents,14 high-frequency keywords were identified and clustered into four categories,in which the keywords most related to IHSS for in-home seniors were community,Ministry of Civil Affairs and nursing.Conclusion There was an obvious structural imbalance in the policy guarantee system of IHSS for in-home seniors,in which the demand-oriented policy tools need to be supplemented and the safeguards for multidimensional collaborative relationships need to be recalibrated.Although the construction goals,bodies and content of IHSS for in-home seniors were clear,it was essential to further improve the consistency between the goals and the content,strengthen the role of traditional Chinese medicine in IHSS for in-home seniors,and refine the policy guarantee system of IHSS for in-home seniors.
作者
邓敏
余曙光
卢圣锋
罗凤琦
Deng Min(School of Health Economics and Management/Jiangsu Research Center for Major Health Risk Management and TCM Control Policy,Nanjing University of Traditional Chinese Medicine,Nanjing,P.R.China)
出处
《中国卫生事业管理》
北大核心
2024年第11期1308-1313,共6页
Chinese Health Service Management
基金
国家自然科学基金资助项目“不同居家养老医养结合模式的供给效率与整合程度的联合评价研究”(71804076)
江苏高校哲学社会科学研究一般项目“积极老龄化背景下中医药健康养老服务共同生产的合作路径研究”(2022SJYB0309)
“江苏省城市养老产业集群生态系统内部演化机理研究”(2023SJYB0307)
江苏省社会科学基金项目“全周期健康视域下江苏中医药健康养老服务体系建构研究”(22GLB012)
2024年度江苏中医药传承创新发展研究基地开放课题“价值驱动个体中医适宜技术使用行为优化策略研究:基于价值共创理论”(JSZYYJD2024B07)
南京中医药大学养老服务与管理学院2023年度专项研究“养老服务产业高质量发展评价及影响因素研究”(2023YLFWYGL007)。
