發(fā)布時間：2018-05-11 12:19

  本文選題：醫(yī)養(yǎng)結(jié)合 + 公立醫(yī)院�。� 參考：《安徽大學(xué)》2015年碩士論文

【摘要】：在人口老齡化不斷加劇的社會背景下,患病老人的養(yǎng)老問題顯得尤為突出和迫切。近年來,全國各地陸續(xù)探索出了“醫(yī)養(yǎng)結(jié)合”這種新型的養(yǎng)老服務(wù)模式,它將“醫(yī)療”與“養(yǎng)老”相結(jié)合,更加強調(diào)醫(yī)療服務(wù)的突出重要性,成為解決患病老人養(yǎng)老問題的重要途徑。本文以合肥市人口老齡化程度高、發(fā)展速度快、未富先老為背景,結(jié)合合肥市人口健康狀況的緊迫形勢,搜集整理了合肥市目前養(yǎng)老機構(gòu)的發(fā)展現(xiàn)狀,指出這些機構(gòu)存在設(shè)施較差、服務(wù)水平參差不齊、醫(yī)療服務(wù)跟不上、人員配備不足、護理人員專業(yè)性不強等諸多問題。為了有效應(yīng)對目前的老齡化形勢,合肥市濱湖醫(yī)院在國內(nèi)較早地探索了“醫(yī)養(yǎng)結(jié)合”養(yǎng)老服務(wù)。2010年該醫(yī)院開設(shè)236張“醫(yī)養(yǎng)結(jié)合”床位,對入住老人實行“醫(yī)保住院”和“托護養(yǎng)老”兩種管理路徑,根據(jù)老人病情變化,在不挪床位的情況下實現(xiàn)兩者之間的輕松轉(zhuǎn)換。文章對濱湖醫(yī)院醫(yī)養(yǎng)結(jié)合病區(qū)的收費標準、成本與收益情況、滿意度情況進行了的調(diào)查和分析,結(jié)果顯示醫(yī)養(yǎng)結(jié)合確實為緩解患病老人的養(yǎng)老問題提供了一種比較理想的解決路徑,但由于床位緊張、成本較高、收費較貴等多種原因,目前濱湖醫(yī)院醫(yī)養(yǎng)結(jié)合病區(qū)只能解決部分患病老人的養(yǎng)老問題,尤其是經(jīng)濟條件較好的、失能程度較高的老人。2013年,合肥市濱湖醫(yī)院所屬的合肥市第一人民醫(yī)院集團將“醫(yī)養(yǎng)結(jié)合”在其旗下的體保中心進行了有效復(fù)制,這為我國部分定位不明確、效益產(chǎn)出不明顯的醫(yī)療機構(gòu)轉(zhuǎn)型提供了有效參考,同時,體保中心對醫(yī)養(yǎng)結(jié)合的范疇進行了擴充,重點開始探索公立醫(yī)院推行居家養(yǎng)老和臨終關(guān)懷兩種“醫(yī)養(yǎng)結(jié)合”服務(wù)。公立醫(yī)院在開展醫(yī)養(yǎng)結(jié)合服務(wù)上有其優(yōu)越性,尤其是能夠?qū)崿F(xiàn)醫(yī)療與養(yǎng)老的無縫對接,還有國家醫(yī)保作支撐。但在醫(yī)養(yǎng)結(jié)合服務(wù)上,實踐走在了政策之前所以在公立醫(yī)院推行醫(yī)養(yǎng)結(jié)合服務(wù)中面臨的突出問題多集中于頂層設(shè)計方面,如政府多頭管理、人才后備力量不足等。為保障公立醫(yī)院推行醫(yī)養(yǎng)結(jié)合服務(wù)的健康良性發(fā)展,首先應(yīng)構(gòu)建一體化的行政協(xié)調(diào)機制,做好頂層設(shè)計。同時,衛(wèi)生行業(yè)在統(tǒng)籌規(guī)劃時,應(yīng)考慮在新建醫(yī)院內(nèi)配比增設(shè)醫(yī)養(yǎng)結(jié)合床位,或?qū)⒉糠轴t(yī)療機構(gòu)轉(zhuǎn)型為醫(yī)養(yǎng)結(jié)合型機構(gòu),以緩解公立醫(yī)院醫(yī)養(yǎng)結(jié)合床位不足的問題。在應(yīng)對人才不足的問題上,應(yīng)將專業(yè)教育與職業(yè)教育相結(jié)合,以區(qū)域內(nèi)成熟的醫(yī)養(yǎng)結(jié)合服務(wù)提供機構(gòu)為平臺,建立專業(yè)人才培養(yǎng)基地。人口老齡化不是中國一個國家的問題,它是世界性難題,而美國、德國、日本在養(yǎng)老問題上的已經(jīng)較為成熟的做法值得中國借鑒,尤其是日本的“介護養(yǎng)老”中對于“介護人才”的培養(yǎng),值得成為我國醫(yī)養(yǎng)結(jié)型人才培養(yǎng)的重要參考模式。
[Abstract]:Under the background of the aging of the population, the problem of aging for the sick elderly is particularly prominent and urgent. In recent years, various parts of the country have gradually explored the "combination of medical care and support", a new mode of old-age care services, which combines "medical care" with "old-age care" and places more emphasis on the prominent importance of medical services. It has become an important way to solve the problem of elderly care for the sick. In this paper, with the background of high aging population, rapid development speed and old age before becoming rich in Hefei, and combining with the urgent situation of population health in Hefei, this paper collected and sorted out the current development situation of pension institutions in Hefei. It is pointed out that there are many problems in these institutions, such as poor facilities, uneven service level, poor medical services, inadequate staffing, and poor professionalism of nursing staff, and so on. In order to effectively cope with the current aging situation, Hefei Binhu Hospital explored the "combination of medical care and nursing" old-age service earlier in the country. In 2010, the hospital opened 236 beds of "combination of medical care and nursing". The two management paths of "medical insurance hospitalization" and "care for the aged" are carried out for the elderly. According to the changes of the elderly's condition, the transition between the two can be realized easily without moving the beds. This paper investigates and analyzes the charge standard, cost and income, satisfaction degree of the medical and nursing ward in the Binhu Hospital. The results show that the combination of medical care and nursing does provide an ideal way to solve the problem of the elderly who are sick. However, because of the shortage of beds, the higher cost and the higher fees, and so on, there are many reasons, such as the shortage of beds, the higher costs and the higher fees. At present, the combination of medical and nursing care in Binhu Hospital can only solve the problem of providing for the aged of some sick elderly people, especially those with better economic conditions and higher degree of disability. In 2013, Hefei City first people's Hospital Group, which belongs to Hefei Binhu Hospital, effectively duplicated the "combination of medical care and nourishment" in its health care center, which is unclear for some of our country's positioning. At the same time, the health care center expanded the scope of the combination of medical care and support, and began to explore the implementation of the home care and hospice care in public hospitals two types of "combination of medical care and maintenance" services. The public hospital has its superiority in developing the combination of medical and nursing services, especially to realize the seamless docking between medical treatment and old-age care, and the state medical insurance as the support. However, in the practice of the combination of medical services and support services, practice before the policy, so in public hospitals in the implementation of the combination of medical and maintenance services faced by the outstanding problems focused on the top-level design, such as government multi-head management, lack of talent reserve, and so on. In order to ensure the healthy and benign development of medical and nursing service in public hospitals, we should first construct an integrated administrative coordination mechanism and do a good job of top-level design. At the same time, in the overall planning of the health industry, consideration should be given to increasing the proportion of beds in new hospitals or transforming some medical institutions into medical and nursing institutions, so as to alleviate the problem of insufficient beds in public hospitals. To deal with the problem of shortage of talents, we should combine professional education with vocational education, take the mature medical and nursing service providers in the region as the platform, and establish the training base of professional talents. The aging of the population is not a national problem in China. It is a worldwide problem. However, the mature practices of the United States, Germany and Japan on the issue of old-age support are worthy of China's reference. In particular, the training of nursing talents in Japan is worthy of becoming an important reference model for the cultivation of medical and nursing talents in China.
【學(xué)位授予單位】：安徽大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：D669.6

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