摘要
目的调查咸宁市医养结合服务发展现状,总结其服务模式及服务内容,分析其发展的优势及现存问题,并提出针对性对策。方法采用方便抽样法,选取咸宁市“一区一市四县”的11所市级医养结合示范机构,以机构内工作人员(机构负责人、养老护理员、医护技人员、养老管理人员)和入住老年人为研究对象,综合运用问卷调查法和实地观察法进行调查。结果入住老年人的整体满意度达到83.33%。咸宁市主要有“医中设养”“养中设医”“医养融合”3种医养结合服务模式,以公办民营和民办性质机构为主,收费标准主要由护理费、床位费、房费和伙食费等决定,服务内容分为医疗和养老两大板块。机构整体环境具有选址布局生态化、环境改造适老化及功能分区模块化3个特征。工作人员从薪资待遇、人员配置、医疗设施、专业培训、养护人才、保险制度方面提出建议,入住老年人从费用补贴、饮食管理、人员数量与质量、家属探视、活动与社会支持方面提出建议。结论咸宁市医养结合服务发展具有形式多样、生态环境优越、公立医院办养老特色鲜明、服务团队年轻化态势良好的优势,但存在尚未纳入长期护理保险试点、养老护理员及部分医疗设施配置未达规定标准、老年人护理分级标准待规范、专业培训与养护人才短板显著的问题。建议完善保障体系,加强财政支持,规范机构内人员、设施配置及护理分级标准,加强服务人员专业化培训,建立多学科养护团队,以推进医养结合服务的高质量发展。
Objective To investigate the development status of integrated medical and elderly care services in Xian‐ning,summarize its service mode and service content,analyze its development advantages and existing problems,and put forward targeted countermeasures.Methods The convenient sampling method was adopted to select 11 municipal exem‐plary integrated medical and elderly care institutions in Xianning,with"one district,one city and four counties".The staff in the institutions(administrators,care staff,medical and paramedical personnel,senior care manager)and elderly resi‐dents were selected as the research subjects,and the survey was conducted by comprehensive use of questionnaire survey and field observation method.Results The overall satisfaction rate of the elderly residents reached 83.33%.Xianning mainly has three integrated medical and elderly care service modes:"medical institutions incorporating eldercare","elder‐ly care institutions incorporating medical services",and"integrated medical and elderly care".These services were primar‐ily operated through public-private partnerships and private-run entities institutions.Fee structures were primarily deter‐mined by nursing fees,bed fees,accommodation charges,and meal expenses.Services encompassed two main compo‐nents:medical care and elderly care.The institution's overall environment was characterized by three features:eco-inte‐grated site selection and layout,age-adapted environmental modifications,and modular functional zoning.Staff recommen dations focused on six areas:salary and compensation,personnel allocation,medical facilities,professional training,multi‐disciplinary elderly care talents,and insurance system.Elder residents'suggestions encompassed five aspects:cost subsi‐dies,dietary management,staff quantity and quality,family visitation,and activities and social support.Conclusions The development of integrated medical and elderly care services in Xianning has the advantages of diverse service models,eco‐logically advantaged environments,distinct characteristics of public hospitals for the elderly care,and the rejuvenation trend in teams shows positive momentum.However,there are some problems that have not been included in the long-term care insurance pilot,the allocation of care staff and part of medical facilities has not reached the prescribed standards,el‐derly care classification standards require standardization,and critical gaps persist in professional training and multidisci‐plinary elderly care talents.It is suggested to strengthen the safeguard mechanisms and financial support,standardize the standards of personnel,facilities configuration and elderly care classification in institutions,strengthen professional train‐ing of service personnel and establish a multi-disciplinary professional care team,so as to promote the high-quality develop‐ment of the integrated medical and elderly care services.
作者
陈阳阳
孔令磷
王鑫源
赵梦遐
廖思颖
王登亚
王雪岩
刘媛媛
胡艺子
胡慕嫣
CHEN Yangyang;KONG Linglin;WANG Xinyuan;ZHAO Mengxia;LIAO Siying;WANG Dengya;WANG Xueyan;LIU Yuanyuan;HU Yizi;HU Muyan(School of Public Health and Health,Hubei University of Science and Technology,Xianning 437100,China)
出处
《老年医学研究》
2025年第4期49-55,共7页
Geriatrics Research
基金
湖北省大学生创新创业训练计划项目(S202310927007,咸宁市公立医院医养结合服务现状及质量提升策略研究)
国家级大学生创新创业训练计划项目(202410927015,护生和老年人对大学生志愿助老服务的意愿及需求研究)。
关键词
医养结合
养老服务
养老管理
老年人
长期护理保险
integrated medical and elderly care
elderly care service
elderly care management
aged
long-term care insurance
