居家社区医养结合服务能力及提升路径研究:基于39个案例的模糊集定性比较分析  

Research on the capacity and improvement path of home-and community-based integrated health and social care:A fuzzy-set qualitative comparative analysis based on 39 cases

作　　者：刘思琦 赵君 刘楠 邓淏晏[1,2] 陈琦 王芳 LIU Si-qi;ZHAO Jun;LIU Nan;DENG Hao-yan;CHEN Qi;WANG Fang(Center of Health System and Policy,Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100020,China;Peking Union College,Beijing 100005,China;School of Health Policy and Management,Chinese Academy of Medical Sciences&Peking Union College,Beijing 100005,China)

机构地区：[1]中国医学科学院医学信息研究所/卫生体系与政策研究中心,北京100020 [2]北京协和医学院,北京100005 [3]中国医学科学院/北京协和医学院卫生健康管理政策学院,北京100005

出　　处：《中国卫生政策研究》2024年第9期28-35,共8页Chinese Journal of Health Policy

基　　金：中国医学科学院医学与健康科技创新工程经费资助项目(2021-I2M-1-046);国家卫生健康委委托项目“2023年社区医养结合能力提升行动”;中国医学科学院医学信息研究所所馆青年人才培养专项资助项目(2024YT13)。

摘　　要：目的:实证分析我国居家社区医养结合服务能力的多元驱动路径,为促进医养结合服务体系完善提供有益参考。方法:基于世界卫生组织老年人综合照护(ICOPE)实施框架构建分析框架,选取我国无锡市、焦作市、长沙市、成都市、重庆市的39个区(县)作为样本案例,采用模糊集定性比较分析(fsQCA)方法剖析高或非高水平居家社区医养结合服务能力的组态路径。结果:居家社区医养结合服务能力的提升是各要素组合作用的结果。研究发现4条路径组合将有助于居家社区医养结合服务能力发展,另有3条路径组合或将阻碍居家社区医养结合服务能力发展;制度环境支持、筹资保障水平与区域老年人口需求程度是其中的关键因素。结论:我国居家社区医养结合服务能力受到多重因素间的相互作用与影响,应从多方面出发共同施策以提升服务能力。Objective:Empirical analysis of the multiple driving paths of service capabilities of home-and community-based integrated health and social care in China,for providing useful reference for promoting the system improvement.Methods:Based on the World Health Organization s Integrated Care for Older People(ICOPE)implementation framework,an analysis framework for service capabilities of home-and community-based integrated health and social care was constructed.39 districts(counties)in Wuxi,Jiaozuo,Changsha,Chengdu,and Chongqing were included.The fuzzy-set qualitative comparative analysis(fsQCA)method was used to analyze the configuration paths of high or non-high-level service capabilities of home-and community-based integrated health and social care.Results:The service capabilities of home-and community-based integrated health and social care is improved by the configuration of various factors.Four path configurations might contribute to the development of service capabilities of home-and community-based integrated health and social care,and three path configurations might hinder the development.Institutional support,financing mechanism and the demand level of regional aging population are the key factors.Conclusions:Service capabilities of home-and community-based integrated health and social care are affected by the interaction and interrelation between multiple factors.Strategies should be jointly implemented from different aspects to improve service capabilities.

关 键 词：人口老龄化 居家社区 医养结合 服务能力 定性比较分析 

分 类 号：R197[医药卫生—卫生事业管理]