What is the combination of medical care and nursing care, and how to do it

1. What is "combination of medical care and elderly care" actually?

        The combination of medical care and elderly care is a new type of elderly care model that has gradually emerged in various places in recent years. Because of its effective combination of modern medical service technology and old-age security model, it has realized the innovation of old-age security model of "treating the sick and recuperating without illness", which has become a hot issue of common concern to government decision-making departments and scholars.

        1. The basic connotation and characteristics of the combination of medical care and elderly care

        The combination of medical care and elderly care has the following basic characteristics:

        From the perspective of security purposes, like the traditional old-age care model, the combination of medical care and nursing care aims to provide old-age living services for the elderly so that they can spend their old age in peace;

        From the perspective of participants, it combines traditional pension institutions and medical institutions, aiming to provide a new type of pension service for the elderly through diversified participants;

        From the perspective of service content, "medicine" refers to the treatment of diseases, and "nurture" refers to the maintenance and rehabilitation of chronic diseases, especially chronic diseases of the elderly.

        From the perspective of protection objects, it is especially suitable for disabled and semi-disabled elderly who cannot receive good care in the traditional pension model, such as those in the recovery period of serious illness, chronic diseases, and patients with relapse-prone diseases;

        From the perspective of human nature, it takes into account both the pension needs and medical needs of the elderly, and meets the basic living needs of the modern elderly.

        Defined in a broad sense, the combination of medical and elderly care is not only an exploration of a new type of elderly care that organically combines traditional pension security with modern medical care, but also means a new leapfrog concept of elderly care.

        All the practice of providing elderly care services that combine medical services and elderly care services can be defined as the category of medical and elderly care integration. Therefore, the combination of medical and elderly care can be understood as "medical and elderly care integration", that is, to go beyond the single elderly care service in the traditional elderly care concept, and to pay more attention to the compatibility of elderly care services and medical services, and to pay attention to the "support" in the elderly's life security needs. The combination with "medicine" can meet the multiple needs of the elderly, disabled, empty nesters, and sick people in the future.

        2. How is the combination of medical care and nursing care different from the traditional model?

        First of all, compared with the traditional model, the difference in service content provided by the two is more obvious. The combination of medical care and elderly care provides specialized medical care and rehabilitation services for patients and the elderly on the basis of providing services including traditional elderly care models and traditional medical care models, and realizes the combination of traditional elderly care services and modern medical services.

        Secondly, the combination of medical care and nursing care is different from the traditional model in that it has a clear responsibility subject, and the combination of medical care and nursing care has no clear responsibility subject. In practice, the combination of medical and elderly care services can be provided by medical institutions with geriatric departments, medical institutions that provide disease treatment and rehabilitation, or even nursing homes and welfare homes.

        Therefore, the combination of medical care and elderly care does not exist as an independent model, but in a more sense, it operates as a new way of supplying elderly care, medical care and rehabilitation services.

        3. Advantages of medical and elderly care institutions

        For a long time, my country's nursing homes can only provide elderly care but not medical care, while hospitals can only provide medical care but not elderly care services. The result of the "separation of medical care and nursing care" in this situation is that the elderly in nursing homes often have to travel between nursing homes and hospitals , not only did not receive timely treatment, but also caused a great burden to the family and the society. On the other hand, due to the inability of nursing homes to provide professional rehabilitation nursing services, many elderly people regard hospitals as "nursing homes". In this way, the medical resources of the hospital cannot be brought into full play.

        The establishment of medical care alliances between medical institutions and elderly care institutions breaks through the separation of resources between elderly care institutions and hospitals, and can form a win-win or even win-win situation: elderly care institutions can integrate the medical resources of hospitals and improve their ability to serve the elderly, and hospitals can Establish a social public welfare image, expand its own influence and the coverage of medical services; getting medical care and care for the elderly can reduce the mental pressure and economic burden of the relatives and children of the elderly.

        2. In China, what are the modes of medical care integration?

        At present, many regions in China have also made some explorations in the combination of medical care and elderly care, and there are mainly four models.

        The first mode is to radiate the medical resources of community hospitals to nursing homes. For example, Shanghai implements the general practitioner model in the central urban area. Through the inspection system and the signing of agreements, the medical resources of community hospitals are radiated to nursing homes in the jurisdiction, and the medical resources are rationally utilized through the tiered medical insurance reimbursement ratio.

        The second mode is that public hospitals dispatch a "small team" of doctors and nurses to stay in nursing homes for a long time. This mode generally only exists in public nursing homes.

        Mode 3: Elderly care institutions invest in hospitals themselves, which are operated by professional medical teams.

        Mode 4, the hospital team directly operates the nursing home. Some existing elderly care service centers are already public elderly care institutions with hospital investment and management. The nursing home with more than 500 beds is provided by the hospital's professional nursing team. In addition to its advantages in medical rehabilitation and chronic disease prevention, it also provides personalized services such as dental fillings and physical examinations.

        3. What are the difficulties in implementing the combination of medical care and elderly care?

        The "aging" phenomenon is prominent, the aging population structure is grim, the "4-2-1" family structure has weakened the elderly care function, and the supply of elderly care services is seriously insufficient...Multiple contradictions such as unique population, economy, society, and management systems have led to medical care. There are multiple problems in the development practice of the combined pension model in our country.

        Therefore, relevant departments should strengthen cooperation, coordinate to formulate corresponding supporting policies, establish unified and perfect pension and medical service standards, standardize medical care behaviors, and ensure the pension and medical needs of the elderly. The government should play a role in implementing support policies such as health access, civil affairs support, and fixed-point medical insurance for medical and elderly care institutions. The health department will approve the medical and elderly care institutions to become medically qualified institutions, and the civil affairs department will confirm their non-profit status. and included in health insurance. This will not only solve the medical and nursing problems of the elderly, but also reduce the economic burden and mental pressure of the elderly and their families, and at the same time promote the improvement of the nursing level of the elderly care industry and the development of the elderly medical rehabilitation industry.

        Fourth, clarify the evaluation criteria for the grades of the disabled and semi-disabled elderly, and achieve full coverage of the health records of the elderly. At present, some regions, including Shanghai and Guangzhou, have begun to formulate operable evaluation systems for elderly care levels.

        Fifth, elderly care services for the disabled should be included in the social security management system. At present, some provinces and cities have taken the lead in implementing the long-term medical care insurance system. The relevant medical care expenses incurred by the disabled elderly who meet the insurance conditions can be paid by the nursing insurance fund. Therefore, it is the general trend to incorporate pension services for the disabled elderly into the social insurance management system. This can greatly alleviate the economic burden of the disabled elderly, further optimize the allocation of medical and pension resources, and improve the efficiency of the use of social security funds.

        Sixth, strengthen the professional construction of nursing teams. The old-age care model that combines medical care and nursing has encountered many difficulties in the exploration, and the lack of professionals engaged in medical care for the elderly has become a common problem faced by old-age medical institutions. Professional medical care services are the guarantee for the elderly to obtain a high quality of life in their later years. At present, the cultivation of professional nursing personnel has not received enough attention. The cultivation of professional personnel has a time cycle. If planning cannot be started from now on, then even with sufficient capital investment and sound legal protection, the shortcomings of human resources will still make the The health and pension business has become a leaky bucket. The elderly care service combined with medical care and nursing is a specialized special service, and it is imperative to carry out multi-level education for the elderly.