健康老龄化视角下老年人全周期健康管理体系构建与实践研究

Construction and Practice of the Whole-Cycle Health Management System for the Elderly from the Perspective of Healthy Aging

摘要: 中国老年人口数量持续增长。老年人健康管理已经成为社会和国家重点关注的内容。当前老年健康服务还存在不少问题。这些问题包括服务不连贯、评估不规范、服务针对性不强、老年人不会使用智能设备、专业人员数量不足。本文立足于健康老龄化理念，整合居家、社区与机构三大服务场景，尝试构建一套覆盖全周期的老年人健康管理体系。该体系包含健康监测、风险评估、慢病管理、康复护理、心理支持、健康教育六个核心模块。在此基础上，本文从服务模式、技术使用、团队建设、资金保障等方面提出了具体的实践路径。本文结合社会工作专业视角，总结了可推广的服务模式。本文可以为老龄化研究和老年服务工作提供参考。它也可以帮助老年人提高健康水平，改善生活质量。

Abstract: The number of elderly people in China is increasing. Health management for the elderly has become an important social issue. There are still many problems in current elderly health services. These problems include inconsistent services, non-standard assessment, insufficient targeted services, digital barriers for the elderly, and shortage of professionals. Grounded in the concept of healthy aging, this paper integrates home, community, and institutional settings to construct a comprehensive whole-cycle health management system. The system includes six parts: health monitoring, risk assessment, chronic disease management, rehabilitation nursing, psychological support and health education. The author puts forward specific methods from service mode, technology application, team building and capital security. From the perspective of social work, this paper summarizes practical service models. It can provide reference for aging research and elderly services. It can also help the elderly improve their health and quality of life.