基于老年人就医行为的医养结合模式政策支持研究  

Research on Policy Support of Integrated Eldercare Services Model with Medical Care Based on the Elderly’s Health Seeking Behavior

作　　者：韦兵 付舒[2] WEI Bing;FU Shu(School of Public Administration,Zhuhai College of Science and Technology,Zhuhai,Guangdong 519041;Institute of Social Research,Guangzhou Academy of Social Sciences,Guangzhou,Guangdong 510400)

机构地区：[1]珠海科技学院公共管理学院,广东珠海519041 [2]广州市社会科学院社会研究所,广东广州510400

出　　处：《长白学刊》2023年第1期131-139,共9页Changbai Journal

基　　金：广东省普通高校重点科研平台和项目“社会嵌入视角下社区居家养老服务供给模式优化策略研究”(2018WQNCX254);广东省哲学社会科学规划2022年一般项目“超大城市智慧养老融入困境的社会因素及治理机制研究”(GD22CSH06)。

摘　　要：以老年人就医行为为切入点检视当前医养结合模式构建中的政策支持问题具有重要的现实意义。通过实证研究发现,医养结合模式建构与老年人就医行为之间存在张力,具体表现为医养结合模式“长期收益”的设计理念与老年人就医“短视”的认知行为间,“资源下沉”的分配机制与老年人“人心上浮”的使用行为间,“市场化”的发展方向与老年人“相对保守”的消费偏好间存在系统性矛盾。政策悬浮是产生张力的来源,表现在医养结合政策宣导不足使老年人的健康自主性未能充分发挥,政策激励不够使老年人就医成本无法社会化分担,政策执行扭曲无法改变由上至下的医疗资源分配逻辑,政策配套缺位忽视了家庭照料者的刚性需求。张力的弥合之道在于,构建以居家社区为主的普惠式医养结合模式,打通医养结合在部门间、场景间和制度间的衔接障碍,提升基层医疗机构开展医养结合服务的能力,催动老年人形成“以健康为中心”的医养结合理念。It is of great practical significance to examine the policy support in the construction of the current integrated eldercare services model with medical care from the perspective of the elderly’s health seeking behavior.Through empirical research,it is found that there are contradictions between the construction of the integrated eldercare services model and the elderly’s health seeking behavior,which is specifically reflected in the contradictions between the design concept of“longterm benefits”and the cognitive behavior of“short-sighted”elderly’s health seeking,between the distribution mechanism of“sinking resources”and the use behavior of“overambitious”of the elderly,and between the development direction of“marketization”and the“relatively conservative”consumption preference of the elderly.Policy suspension is the source of contradictions,which is manifested in the following aspects:insufficient policy advocacy of integrated eldercare services model with medical care fails to give full play to the health autonomy of the elderly,insufficient policy incentives make it impossible for the elderly to share the cost of medical care in a social way,distorted policy implementation cannot change the top-down medical resource distribution logic,and the lack of policy support ignores the rigid needs of family caregivers.In order to optimize the development of the model,it is necessary to build an inclusive model based on family and community,break through the barriers of different departments,scenes and systems,improve the ability of grass-roots medical institutions,and promote the elderly form a“health-centered”concept of integrated eldercare services with medical care.

关 键 词：老年人就医行为 医养结合模式 政策支持 

分 类 号：D669.3[政治法律—政治学] D669.6[政治法律—中外政治制度]