上海失能失智老人健康服务保障体系研究  

Study on Health Service Support System for Aged Citizens with Disability and Cognitive Dysfunction in Shanghai

作　　者：胡亚琼 万曜 达罗 田晓洁[1] 邵志民[1] HU Ya-qiong;WAN Yao;DA Luo(Huadong Hospital,Fudan University,Shanghai,200040,China;不详)

机构地区：[1]复旦大学附属华东医院,上海200040 [2]日喀则市人民医院,西藏日喀则857000

出　　处：《中国卫生经济》2021年第3期55-60,共6页Chinese Health Economics

基　　金：上海市卫生健康委员会政策研究课题项目(2020HP22)。

摘　　要：目的:从建立健全上海失能失智老人健康服务保障体系的视角,通过政策分析、实证研究和归纳梳理,对老年群体,尤其是高龄、失能失智老人的实际需求开展调研,发现不同生物学特性的老年群体在"医养结合"上门服务项目的选择偏好上存在差异。方法:选取共建合作关系的老龄服务行业主管部门或机构的服务对象共401人开展调研,进行统计学分析。结果:针对筛选出的6类23个服务项目:(1)失能失智老人(80.7%)比健康高龄老人(62.5%)、健康低龄老人(51.0%)对上门照护服务的需求更强烈(P=0.000);(2)失能失智老人(32.6%)比健康高龄老人(25.0%)、健康低龄老人(11.0%)享受长期护理保险的比例更高(P=0.000);(3)在医疗类、家政类、清洁类、生活类、移动类、看护类服务项目方面,健康低龄老人、健康高龄老人的需求相较于失能失智老人更高(P值均小于0.05)。结论:提升失能失智老年人的生存质量,实现老年群体"未病先防,既病防变,愈后防复"的目标,公立医院、康复中心、社区卫生服务中心、社区是在医养结合的服务主体,需要有效配合、有序衔接、有机整合。建立健全与上海国际大都市生活品质相适应的失能失智老人健康服务保障体系,以家庭医生签约制为基础,做好健康守门人;以互联网医疗为驱动引擎,做强线上联络人;以长期护理保险制度为依托,做好专业吹哨人;以专业化职业化为发展方向,做实行业局内人,为老年人提供从专业医疗康复护理到生活照护等全方位、全流程的医养服务。Objective:From the perspective of establishing and improving the health service security system for the disabled and mentally retarded elderly in Shanghai,policy analysis,empirical research and induction are applied to investigate the actual needs of the elderly groups,especially the elderly and the disabled and mentally retarded elderly.It finds that there are differences in the selection preference of"combination of medical and nursing"home-based services among the elderly groups with different biological characteristics.Methods:A total of 401 people from the departments or institutions in charge of the aging service industry are selected to carry out the research and statistical analysis.Results:According to the selected 23 service items out of 6 categories:(1)the disabled and mentally retarded elderly(80.7%)have stronger demand for home-based care service than healthy elderly(62.5%)and healthy young elderly(51.0%)(P=0.000);(2)the disabled and mentally retarded elderly(32.6%)had higher proportion of long-term care insurance than healthy elderly(25.0%)and healthy young elderly(11.0%)(P=0.000);(3)in terms of medical,housekeeping,cleaning,living,mobile and nursing services,the demand of healthy young and healthy elderly is higher than that of disabled and mentally retarded elderly(P<0.05).Conclusion:It needs to improve the quality of life of the disabled and mentally retarded elderly,realize the goal of"prevention before disease,prevention after disease,prevention after recovery".Public hospitals,rehabilitation centers,community health service centers and communities are the service subjects in the combination of medical and nursing services,which need effective cooperation,orderly connection and organic integration.It needs to establish and improve the health service security system for the disabled and mentally retarded elderly,which is suitable for the quality of life of Shanghai international metropolis,so as to be a good health gatekeeper based on the family doctor contract system.It needs to be a strong onl

关 键 词：失能失智老人 医养结合 上门照护服务 上海 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R195