【摘要】：面對我國社會老齡化程度逐步加深,我國失能、半失能老年人口數(shù)量日益增多的現(xiàn)實國情,傳統(tǒng)的家庭養(yǎng)老服務(wù)已難以滿足老年群體的養(yǎng)老需求,特別是大多數(shù)的高齡、患病老人需要醫(yī)療診治、疾病預(yù)防、健康咨詢、康復(fù)指導(dǎo)等醫(yī)療服務(wù),養(yǎng)老問題成為社會各界關(guān)注與熱議的民生問題之一。在2013年,我國首次提出醫(yī)養(yǎng)結(jié)合概念,將醫(yī)養(yǎng)結(jié)合模式作為解決未來我國養(yǎng)老服務(wù)業(yè)的發(fā)展趨勢,也是保障老年人健康養(yǎng)老的創(chuàng)新模式。但在現(xiàn)實的實踐過程中,我國的醫(yī)養(yǎng)結(jié)合面臨制度不完善、缺乏專業(yè)化護(hù)理人才、資金不足等多方面的困難,為現(xiàn)有模式提出優(yōu)化建議是本文研究的重要因素。本文以人權(quán)理論、福利經(jīng)濟(jì)學(xué)理論和多元主體參與作為理論依據(jù),綜合運(yùn)用文獻(xiàn)研究、訪談法與案例分析等研究方法,針對我國醫(yī)養(yǎng)結(jié)合的現(xiàn)實背景與運(yùn)作模式現(xiàn)狀進(jìn)行研究,結(jié)合試行推廣過程中出現(xiàn)的困境,提出醫(yī)養(yǎng)結(jié)合模式的優(yōu)化路徑,為政府進(jìn)一步推廣醫(yī)養(yǎng)結(jié)合提供建議。本文由六個部分組成,首先在闡述醫(yī)養(yǎng)結(jié)合相關(guān)概念與理論依據(jù)的基礎(chǔ)上,以我國深度老齡化的現(xiàn)狀為切入點(diǎn),提出我國發(fā)展醫(yī)養(yǎng)結(jié)合模式的現(xiàn)實背景。其次提出國家和地方政府提供大力支持、醫(yī)療衛(wèi)生事業(yè)改革提供契機(jī)的優(yōu)勢條件,詳細(xì)概述國家衛(wèi)計委提出未來可以推廣的四種醫(yī)養(yǎng)結(jié)合模式。之后以北京市的養(yǎng)老機(jī)構(gòu)和朝陽社區(qū)為例,分別介紹這四種模式的典型案例與成功經(jīng)驗。然而,現(xiàn)實醫(yī)養(yǎng)結(jié)合模式的發(fā)展面臨許多現(xiàn)實困境,最后提出我國發(fā)展醫(yī)養(yǎng)結(jié)合模式的建議,即協(xié)調(diào)相關(guān)部門的職能,設(shè)立第一責(zé)任部門;完善頂層制度設(shè)計,建立針對養(yǎng)老機(jī)構(gòu)與老年人身體健康狀況的評估制度;將社會資本與社會力量引入到養(yǎng)老行業(yè),實現(xiàn)多元化籌資模式;從國家、行業(yè)和學(xué)校三個角度,培育專業(yè)護(hù)理人員,養(yǎng)老機(jī)構(gòu)完善人才管理制度;建立長期護(hù)理保險制度與簽約家庭醫(yī)生制度,推動醫(yī)養(yǎng)結(jié)合工作的開展。
[Abstract]:In the face of the reality that the degree of aging in our country is gradually deepening, the number of disabled and semi-disabled elderly population is increasing day by day, the traditional family old-age service has been difficult to meet the needs of the elderly, especially the majority of the elderly. Elderly patients need medical treatment, disease prevention, health counseling, rehabilitation guidance and other medical services. In 2013, the concept of combination of medical care and support was first put forward in our country. The model of combination of medical care and support was regarded as the developing trend of the service industry for the aged in the future, and it was also an innovative model to guarantee the health of the elderly. However, in the practical process, the combination of medical and nursing is faced with many difficulties, such as imperfect system, lack of specialized nursing personnel, insufficient funds and so on. It is an important factor for this paper to put forward the optimization suggestions for the existing model. Based on the theory of human rights, the theory of welfare economics and the participation of multiple subjects, this paper makes a comprehensive use of literature research, interview and case analysis to study the realistic background and operating mode of the combination of medical and nursing in China. Combined with the difficulties in the process of trial extension, the optimized path of the combination of medical and support is put forward, which provides suggestions for the government to further promote the combination of medical and support. This paper is composed of six parts. Firstly, on the basis of expounding the related concepts and theoretical basis of the combination of medical and nursing, and taking the current situation of deep aging in China as the starting point, the paper puts forward the realistic background of developing the mode of combination of medical and nursing in China. Secondly, the state and local governments to provide strong support, medical and health reform to provide opportunities for the advantages of conditions, a detailed outline of the State Health and Family Planning Commission can promote the future of the four types of medical care combined mode. Then taking Beijing pension institutions and Chaoyang community as examples, the typical cases and successful experiences of these four models are introduced. However, there are many practical difficulties in the development of the model of combination of medical care and support. Finally, the suggestion of developing the mode of combination of medical and nursing is put forward, that is, to coordinate the functions of relevant departments, to establish the first responsible department, and to perfect the design of the top-level system. To establish an evaluation system for the health of the aged and the health of the elderly; to introduce social capital and social forces into the pension industry, and to achieve a diversified funding model; to cultivate professional nursing personnel from three perspectives: the state, the industry and the school. The old-age institutions should perfect the talent management system and establish the long-term nursing insurance system and the contract family doctor system to promote the development of the combination of medical care and support.
【學(xué)位授予單位】：山西大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.1;D669.6

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本文編號：2201050