医养结合的中期照护服务——理念、现存问题及专业化发展路径  

Intermediate Care in Medical and Care Integration:Concept,Exsiting Problems and Professional Development Path

作　　者：张静 高俊岭[3] 乔晓春[4] ZHANG Jing;GAO Junling;QIAO Xiaochun(School of Public Administration,Jilin University,Changchun 130015,China;Policy Research Center,Ministry of Civil Affairs,Beijing 100721,China;School of Public Health,Fudan University,Shanghai 200032,China;Institute of Population Research,Peking University,Beijing 100871,China)

机构地区：[1]吉林大学行政学院,吉林长春130015 [2]民政部政策研究中心,北京100721 [3]复旦大学公共卫生学院,上海200032 [4]北京大学人口研究所,北京100871

出　　处：《人口与经济》2024年第3期30-42,共13页Population & Economics

摘　　要：中期照护作为世界卫生组织推出的整合式连续性服务模式的重要环节,旨在恢复健康和自立生活,具备医养结合的典型特征,也是未来养老服务发展的一个重点领域。基于康复护理视角探索我国中期照护的专业化发展路径,认为中期照护可以填补老年人从医院回到社区和家庭期间出现的照护“真空”,能够起到预防老年人失能、残疾的作用,是实施积极应对人口老龄化国家战略的一项重要举措。从我国发展中期照护制度的现实需要和问题分析出发,总结发达国家和地区中期照护模式,将其归纳为机构型、社区型和居家型。其中机构型包含护士主导病房(nurse-led units)、老年日间病房(geriatric day-hospital)等机构嵌入服务,以及康复护理院或医护疗养院(nursing home)等独立机构。并借鉴其在组织体系、筹资及支付机制、服务内容、服务人员、质量监控等方面的专业经验,探讨我国中期照护的专业化发展路径。未来应加强养老保障中照护制度的顶层设计,完善多部门协同管理体系,建立健全老年综合评估体系,建设康复护理专业机构,制定服务标准和规范,跨学科培养组建专业团队,整合医保支付等多元筹资方式。As the important segment of integrated continuous service model recommended by World Health Organization(WHO),the intermediate care points to the restoration of health and independent living.Its service process links hospitals(institutions)and families to include the medical and social care,with the typical characteristics of medical and care integration,which is also a major field of older adults service in the future.From the review of existing literature,the domestic and foreign research on intermediate care is mainly concentrated in the medical field.Based on the perspective of rehabilitation nursing service,this paper explores the professional development path of China’s intermediate care system arguring that the intermediate care can fill“vacuum”of care during the elderly’s return from hospitals to communities and families and play a role in preventing the disability and disability of the elderly,which is an important initiative to implement the strategy of actively responding to population aging.The paper proceeds from the practical need and problem analysis of intermediate care in China,summarizing the intermediate care models of the developed countries and regions,which are divided into institution-based type,community-based type and home-based type.The institution-based type includes institution-embedded services such as nurse-led units and geriatric day-hospitals,as well as independent institutions such as rehabilitation residential homes and nursing homes.Therefore,the paper suggests that we should learn from their advanced experience in the following aspects:the organizational systems,financing and payment mechanisms,service content,service staff and quality monitoring.Finally,the paper discusses the development path of our country’s intermediate care system,which includes strengthening the top-level design of intermediate care in the social security system for older adults,improving the multi-department collaborative management system,establishing and perfecting the comprehensive assessmen

关 键 词：中期照护 康复护理 养老服务 医养结合 专业化 

分 类 号：C913.6[经济管理]