Analysis of Professional Quality Cultivation Strategies for Infant and Child Care Service Talents from the Perspective of Collaboration of Medical Care,Parenting,and Education,and Integration of Industry and Education

The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.

Implementation Strategy of“Eight in One”of Integrated Medical and Care Service System in China:A Case Study of Anshan City of Liaoning

With the gradual intensification of aging in China,the issue of elderly care has become the primary issue that needs to be urgently solved in society.The construction of a reasonable and scientific integrated medical and care service system can not only efficiently allocate medical resources and services,but also better meet the needs of the elderly.Due to the involvement of multiple disciplines such as architecture,sociology,psychology,and behavioral science in the construction of the system,as well as the restriction of various objective factors such as medical capacity,spatial scale,and operating costs,the government and elderly care institutions have always been unable to find the best solution for how to scientifically and reasonably construct an integrated medical and care service system.This paper is based on Anshan City,Liaoning Province,which has prominent aging issues and distinct characteristics of the elderly population.Through extensive field research in elderly care institutions,and face-to-face communication with personnel from relevant government departments such as the Municipal Commission on Aging,the Civil Affairs Bureau,the Health Commission,the Medical Insurance Bureau,and the Human Resources and Social Security Bureau,it truly understands the problems that arise in the construction of the urban integrated medical and care service system.From three aspects:urban situation,institutional situation and the needs of the elderly,it is proposed to establish a clear departmental linkage mechanism with clear rights and responsibilities,a policy guarantee mechanism tailored to local conditions,a multi-measure operation mechanism,a technology first intelligent response mechanism,a warm and efficient service mechanism for the people,an overall layout mechanism,an evaluation and supervision mechanism for full process control,and a talent supply mechanism of external introduction and internal training.It aims to provide reference for the construction of an integrated medical and care service system in similar cities.

Clinical Efficacy of the Integrated Medical Care Model Combined with Psychological Intervention in Tuberculosis Patients with Lung Cancer

Objective:To explore the clinical efficacy of the integrated medical care model combined with psychological intervention in pulmonary tuberculosis patients with lung cancer.Methods:From January to December 2022,60 pulmonary tuberculosis patients with lung cancer admitted to our hospital were selected as the research subjects.Using the random number table method,the patients were divided into two groups,a control group and a study group,with 30 cases in each group.The chest computed tomography(CT)examination results,mental state assessment(including depression scale and anxiety scale)scores,incidence of adverse reactions,treatment effect,and length of hospital stay were compared between the two groups.Results:The treatment effect of the patients in the study group was better than that of the patients in the control group(P<0.05);the duration of hospitalization,chest CT examination results,mental state assessment scores,and incidence of adverse reactions of the study group and the control group,were significantly different(P<0.05).Conclusion:The integrated medical care model combined with psychological intervention can effectively improve the treatment effect of pulmonary tuberculosis patients with lung cancer and prevent the occurrence of adverse reactions;thus,it should be promoted in clinical practice.

Observation on the Effect of Integrated Medical and Nursing Care in Patients with Pulmonary Tuberculosis Combined with Lung Cancer

Objective:To explore the effect of integrated medical and nursing care in patients with pulmonary tuberculosis combined with lung cancer.Methods:From August 2021 to August 2022,60 patients with pulmonary tuberculosis combined with lung cancer were admitted.All patients were diagnosed with pulmonary tuberculosis according to the Guidelines for the Diagnosis and Treatment of Pulmonary Tuberculosis and with lung cancer by pathology.The patients were randomly divided into two groups,with 30 cases in each group.The control group received daily nursing care,whereas the study group received integrated medical and nursing care.The sputum conversion rate,tumor remission rate,and quality of life of patients were observed and analyzed.Results:The item function score and symptom function score of the observation group were higher than those of the control group(P<0.05);the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the sputum conversion rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:For patients with pulmonary tuberculosis combined with lung cancer,the application of integrated medical and nursing care can help consolidate the treatment effect and improve the quality of life of patients;thus,it is worthy of promotion and application.

Integration of Medical Care and Endowment: A New Exploration of Endowment Mode in the Context of Population Aging

China's aging pressure is increasingly serious. The elderly people are difficult to seek medical advice,the elderly dependency ratio is soaring,finance fails to bear such heavy load,and social endowment service pressure is also constantly increasing. Traditional endowment mode is already incapable of satisfying current endowment demands. On the basis of the population aging,this paper came up with the new endowment mode " hospital + nursing home" and analyzed its feasibility. Finally,it reached the conclusion that this endowment mode is helpful for solving problems of endowment and medical care,and alleviating the problem of population aging.

Exploration on the Implementation of the Integration of Medical and Preventive Model in China’s Primary Health Care Institutions

Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interviews,and other methods the implementation status was evaluated to systematically study the main experience and effect of implementing medical and preventive integration services in pilot areas.Results and Conclusion At present,there are three implementation modes of medical-prevention integration,namely,vertical mode based on the medical community,internal mode with optimized service process,and internal mode with great service capabilities.The three medical-prevention integration modes have their respective focuses,but they need to be further improved in terms of policy support,technical staffing,information system construction,and drug use.

Research of the Exploitation of Human Resources in Blind Prevention and Primary Eye Care

Purpose:This research studied how to establish a relatively advanced blindness prevention and eye care cause in economically underdeveloped countryside.Methods:Ophthalmic vocational schools and professional lectures were held to train“practical type”primary eye care workers for the coumtryside.Further study in high-level(above provincial)hospitals was taken to train blindness preention &eye care backbones and leaders.Results:In 1986,the ratio of the number of the eye care workers of all levels to the number of the whole population in the prefecture was1:26000.In1992,it roseto1:17000.Aneye care network of 222stations had been established in tb countryside.Ten in the 13county hospitals had a seperated ophthalmology ed- partment,in which 3were awarded“National advanced blindness prevention County”.Twenty one hospitals were appointed as the Unit of Surgical Vision-Rehabilitation of Cataract.Blindness prevention and eye care convered1000000population(eye care avaliable within 5kilometers),23.5%of the whol popula-tion.Conclusions:In a demographically large but economically underdexeloped country-side area,the key to wide-range blindness prevention and eye oare is to exploti human resources effectively.We should train“Practical type”primary eye care workers,and have a number of edpartment leaders who are authoritive,influential in this field and ready to sacrifice to this cause.

Telemedicine System Based on Medical Consultation Assistance Integration

With the aging of the global population, how to provide effective telemedicine for the aging population has become a very important issue, especially for the elderly with limited mobility. If there is a complete telemedicine system, it will not only greatly improve medical efficiency. It can reduce the chance of contact between people and avoid the medical risks caused by severe special infectious pneumonia. This paper focuses on the development of a high-efficiency telemedicine system platform that conforms to international standard data exchange formats. This system platform can not only solve the problem of shortage of medical staff but also allow patients to be free from medical outpatient time constraints. Achieve the effect of telemedicine at any time, and digitize the medical process rules to establish a complete online telemedicine system platform.

Retrospective analysis of hepatitis C infected patients treated through an integrated care model

AIM To determine if our health system's integrated model reflects sustained virologic response(SVR) outcomes similar to those in clinical trial data, maximizes adherence, and averts drug interactions.METHODS Subjects with chronic hepatitis C had their medical records reviewed from November 1st, 2014 through March 1st, 2016. Patients eligible for treatment were entered into an integrated care model therapy algorithm. The primary outcome was SVR12 based on intention to treat(ITT) analysis. Inclusion criteria consisted of both treatment na?ve and experienced patients over the age of 18 who were at least twelve weeks post-therapy completion with any genotype(GT) or METAVIR score. Secondary outcomes included adherence, adverse events, and number of drug interaction interventions.RESULTS At the time of analysis, 133 patients had reached twelve weeks post therapy with ITT. In the ITT analysis 70 patients were GT 1a, 26 GT 1b, 23 could not be differentiated between GT 1a or 1b, 8 GT 2, 4 GT 3, and 2 patients with multiple genotypes. The ITT treatment regimens consisted of 97 sofosbuvir(SOF)/ledipasvir(LDV), 8 SOF/LDV and ribavirin(RBV), 7 SOFand Simeprevir(SMV), 6 3D and RBV, 1 3D, 11 SOF and RBV, and 1 SOF, peg interferon alpha, and RBV. The overall SVR12 rate was 93% in the ITT analysis with a total of 6 patients relapsing. In patients with cirrhosis, 89% obtained SVR12. All 33 patients who were previous treatment failures achieved SVR12. Drug-drug interactions were identified in 56.4% of our patient population, 69 of which required interventions made by the pharmacist. The most common side effects were fatigue(41.4%), headache(28.6%), nausea(18.1%), and diarrhea(8.3%). No serious adverse effects were reported.CONCLUSION Dean Health System's integrated care model successfully managed patients being treated for hepatitis C virus(HCV). The integrated care model demonstrates high SVR rates amongst patients with different levels of fibrosis, genotypes, and HCV treatment history.

Integrating Psychiatric Services into Comprehensive Dementia Care in the Community

Purpose: This study was conducted to clarify the utility of patient-held records as an integrated care approach for patients with dementia in the community. Method: We analyzed the family-held/patient-held records of patients with dementia in the community. The inclusion criteria in the study were as follows: 1) patient-held/family member-held records of patients with dementia in the community;2) patient-held records designed to share information across different professionals, direct-care staff members, and local government staff;and 3) the continuous participation of psychiatrists in the development and use of the patient-held records. Results: We identified eight sets of family-held/patient-held records in Japanese communities of various sizes, all of which were aimed at integrating information from various services, including information provided by medical and psychiatric professionals to the family and patient. Innovative tools have been available in the areas of the hopes and preferences of the patient, medication and monitoring, sharing information, and the use of information technology. Conclusion and Discussion: Family-held/patient-held records have potential as a tool to enhance the integrated care of people with dementia in the community.

Identifying the Determinants for Attractiveness of Integrated Forms of Care from the Perspective of Health Care Professionals

Fostering integration between caregivers in the ambulatory sector involves transforming the institutional, organizational and technical flamework but also redesigning the work performed by health care professionals. Empirical research on the implementation of integrated care highlights professional engagement and commitment as a key success factor during the change process. Although a mismatch of motives during the integration process is often reported only a few studies have explored motivational aspects of health care integration. The aim of this study is to explore motivational factors for health care professionals in order to identify the determinants of attractiveness of integrated forms of care. An online-questionnaire was developed to identify the most important motivational factors for health care professionals and to reflect their perceptions on the attractiveness of interdisciplinary forms of care. The sample includes practicing physicians （general practitioners and specialists）, practicing nurses and non-physician professions （physiotherapists, midwives, speech therapists, occupational therapists）. Findings suggest that health care professionals are highly motivated by intrinsic motivators. Physicians turned out to be the most reluctant group towards integrated care models. Participating in integrated forms of care would challenge working independently which represents a strong motivator. The responses of nurses suggest that they are the most favorable group. Integrated care forms would be attractive offering more possibilities for social relationships, expanding responsibilities and challenging work. Results support the importance of health workforce engagement and participation in planning health care integration.

The Study on the Process and Impact of External-Care-Seeking Behavior in Shanghai

Objectives: To evaluate the impact of external-care-seeking, explore the framework to regulate patients’ seeking doctor behavior and to promote better medical resources allocation. Methods: Obtaining data from regular reports from public medical institutions in Shanghai, comparing patients who seek doctors from out-of-Shanghai residence and local patients with insurance in terms of the quantity of service, types of diseases, medical expenses, etc. Results: External-care-seeking has a large quantity, especially in hospitalization. In 2012, the number of discharged population from out-of-Shanghai accounted for 22.74% of the total discharged number, the proportion even higher than 30% in tertiary hospitals. Tertiary hospitals have a significant attraction effect, concentrating 59.42% of the outpatient and emergency visits and 71.82% of the amount of hospitalization, with corresponding cost of 75.86% and 82.56%. The top three divisions in tertiary hospitals for external-care-seeking were surgical, obstetrics and gynecology, internal medicine. Based on the interview, admitting out-of-shanghai patients is conducive to the improvement of the technical level of hospitals, and to the enhancement of the utilization efficiency of health resource. However, the local residents may have less accessibility of high quality of medical service. The average expense of external-care-seeking is higher than that of local patients happened in the same level of hospitals. Conclusions: External-care-seeking will have a more far-reaching impact on the health care system in Shanghai;some interventions might be necessary, such as rationally allocating medical resources based on the estimates of external-care-seeking and establishing a medical service supervision mechanism.

基于文献和知识学习的重症医学大语言模型探索

目的:通过大语言模型技术学习重症医学专科的临床知识,理解和识别临床医疗需求和临床问题意图,并对临床用户提出的问题进行智能反馈。方法:在通用大语言模型的基础上,进行医疗大语言模型数据集的设计,并收集大量的医学知识数据进行多任务多阶段的大语言模型训练,实现对重症医学临床信息的智能分析。结果:实现对重症医学临床医疗信息的智能化理解及自动化问答。结论:应用医疗大语言模型技术,结合临床规则库、医学文献等外部知识体系,可构建重症临床信息大语言模型系统,为临床医疗提供科学、智能的信息理解和决策支持,为大语言模型技术在医疗领域的进一步研究和应用提供经验和参考。

居家社区医养结合服务利用及满意度现状研究

目的 了解居家社区医养结合服务的利用情况和满意度现状,提出促进医养结合发展的对策和建议。方法 通过目的抽样法于2023年5-7月在我国东、中、西部分别选取无锡市、长沙市、成都市对2 125名60岁及以上正在接受或曾接受过服务的老年人进行问卷调查。采用描述性分析、卡方检验、单因素方差分析、多元线性回归等统计学方法对有效问卷数据进行分析。结果 不同地区的就医习惯、服务方式、常用药的获取情况差异具有统计学意义(P<0.05)。服务总体满意度均值为(4.32±0.625)分,处于“满意”与“非常满意”之间。线性回归结果显示,失能程度、慢性病患病情况、地区差异、就医习惯、服务方式、常用药获取情况、地理可及性情况是服务满意度的影响因素(P<0.05)。结论 老年人所接受的居家社区医养结合服务对于基层医疗卫生机构利用情况较好,服务总体满意度较高,但存在地区之间发展不平衡的问题。应进一步以基层医疗卫生机构为重点发展居家社区医养结合服务,完善医保支付机制,加快建立健全长护险制度,不断提高居家社区老年人的满意度和居家社区医养结合服务质量。

我国养老产业发展“拐点”研判——基于多案例研究的典型事实

随着人口老龄化进程加速,我国的养老需求结构正在从生存型向发展型转变,这将为养老产业的发展带来广阔的市场空间,但当前我国养老产业发展相对滞后,仍面临严重的发展困境。我国养老产业发展的“拐点”何时到来?为回答好这个问题,本文以案例研究和实证分析相结合的研究框架,首先,以法、德、日、美四国为例,系统梳理其养老产业发展历程,总结归纳出养老产业发展“拐点”出现的共性特征;其次,聚焦日本养老产业发展轨迹,重点关注其介护险实施前后养老产业相关重要指标变化;最后,选取九个养老产业相关指标,基于指数平滑、灰色模型等方法对中国养老产业未来情况进行预测,并与日本可比时期指标情况进行比较,判断中国养老产业“拐点”出现的可能时间。研究发现:养老产业发展“拐点”的出现具有四个共性特征,分别是三支柱养老金体系改革、长护险制度全面实施、多元化服务助推医养结合、代际转换背后的产业增量机会,而中国养老产业发展“拐点”可能出现的窗口期将在2026—2030年间。

健康老龄化视域下“医养结合嵌入式”养老服务的质量评价研究

健康老龄化视角下的嵌入式医养结合养老模式是未来老年人养老质量的保障,也体现了老年人对未来老年幸福美好生活的需求。但对该模式的研究多集中在理论研究层面,对实证的研究较为缺乏。本研究基于医养结合的嵌入式养老服务的评价方法和评价原则,对构建嵌入式医养结合养老模式的评价指标体系进行了较为详尽的阐释。发现目前嵌入式养老机构重在养老轻在医疗,医疗机构与养老机构之间存在着衔接不足的问题,具体表现在医护人员的服务主体不够专业、服务项目不够落实、医疗机构与养老机构的资源整合碎片化以及机构管理的多头监管等问题。研究针对相关问题提出了建议,对我国医养结合的嵌入式养老模式的进一步实施具有一定借鉴意义。

城乡融合发展背景下农村养老难题破解路径

城乡融合发展已成为我国加快实现农业农村现代化进程中高度关注的重要命题,而农村养老问题是制约我国城乡融合发展的重要因素。长期以来,农村养老存在经济资源不足、养老服务主体缺失、农村老人精神贫困等诸多难题,农村养老供需结构性矛盾突出。城乡融合发展背景下,应通过增强土地养老功能,缩小城乡社会保障水平差距,鼓励发展城乡互动养老模式,依托文化和自然资源发展乡村旅居养老,数字赋能农村智慧养老等措施,积极引导城市各项资源下乡,充分利用农村闲置资源,有效解决农村养老难题。

健康中国背景下的“看病贵”与政府支出——基于资源配置结构性失衡视角的分析

“看病贵”意味着医疗卫生资源转化为医疗卫生服务的成本高,有限资源下医疗卫生服务供给的数量和质量难以满足公众健康需求,从而直接影响健康中国建设。同时,人口快速老龄化带来的医疗卫生需求爆发式增长,将形成医疗卫生体系的额外压力,加剧供求矛盾。基于医疗卫生资源配置结构性失衡视角研究“看病贵”与政府支出之间的关系发现:政府增加卫生支出会通过加剧人力资源配置的结构性失衡而加剧“看病贵”问题;只有将增加政府卫生支出与深化医疗卫生体制改革相结合,才能真正缓解全社会“看病贵”问题。因此,应深化公立医院改革,优化政府对医疗卫生资源的配置方式,加强基层医疗卫生体系建设,重塑医疗卫生服务治理模式,构建专业化治理模式,系统性重构中国医疗卫生领域人才建设。

农村医养结合型养老服务政策的演进逻辑

伴随着健康中国战略的稳步推进,我国农村医养结合型养老服务体系经历了从供给不足到供需相对均衡的发展过程,逐步形成了与经济社会持续健康发展相协调的高质量社会养老服务体系,在满足公众需求、缓解社会矛盾、促进社会公平、增进老年福祉等方面发挥了重要作用。深入挖掘其在政策目标、政策内容、价值取向等方面的阶段性特征和变化趋势,通过社会网络分析发现,我国农村医疗卫生与养老服务相结合由点到面逐步拓展,二者由彼此独立走向有机融合,其结合、融合与整合的体制机制逐渐成熟,二者相结合由逐步成熟向深度融合阶段迈进。为了促进医养结合政策的有效衔接,我国应加快推进农村医养结合型养老服务体系建设,以县域医共体为核心发展农村医养结合型养老服务,探究不同类型政策工具之间的合理匹配,全方位提高农村医养结合型养老服务质量,不断提升老年人健康保障水平。

某大型公立医院医养结合模式实践探索

随着人口老龄化程度的加深以及医疗需求的增加,家庭病房作为一种医养结合服务模式逐渐受到重视,成为一种对医疗资源紧缺的重要补充手段。广东省第二人民医院建设智慧家庭病房,探索实践医养结合“互联网+养老”新模式。本文以广东省第二人民医院建设智慧家庭病房的医养结合实践为对象,探索分析公立医院医养结合“互联网+养老”模式在应用中存在的问题,并提出相应的对策建议。