医疗卫生机构嵌入养老服务发展现状及优化策略研究——基于贵州省的调查分析

Research on the Development Status and Optimization Strategy of Embedded Elderly Care Services in Medical and Health Institutions—Based on the Investigation and Analysis of Guizhou Province

摘要: 传统医疗与养老资源分开配置的方式难以满足老年人整体性健康养老需求，而医养结合服务因其能最大程度整合医疗服务和养老服务资源，为老年人提供连续性的健康服务，从而成为积极应对人口老龄化的一大政策创新。本文在嵌入性理论的视角下，阐释医疗卫生机构从结构和关系上嵌入养老服务的逻辑，同时，基于贵州省医养结合的调查，了解医疗卫生机构嵌入养老服务的模式和现实困境，总结出结构式嵌入养老服务上存在服务效率低、供给乏力、医养人才紧缺、资源利用不畅通，关系式嵌入养老服务上有量无质，签约流于形式。为此，要从顶层设计上打破行政壁垒，配置长效保障机制，从软件和硬件上优化资源配置，精准定位服务，推动医疗卫生机构医养结合服务的发展。

Abstract: It is difficult for traditional medical and old-age care resources to be allocated separately to meet the overall health care needs of the elderly. However, the combination of medical and old-age care services has become a major policy innovation to actively respond to the aging population because it can integrate medical and old-age service resources to the greatest extent and provide continuous health services for the elderly. From the perspective of embeddedness theory, this paper explains the logic of embedding elderly care services in the structure and relationship of medical and health institutions. At the same time, based on the investigation of the combination of medical and nursing care in Guizhou Province, it understands the mode and practical dilemma of embedding elderly care services in medical and health institutions, and concludes that there are low service efficiency, lack of supply, shortage of medical and nursing talents, and unimpeded utilization of resources in the structural embedding of elderly care services, the relationship embedded in the elderly care service has quantity but no quality, and the contract is just a formality. To this end, it is necessary to break the administrative barriers from the top-level design, configure a long- term guarantee mechanism, optimize the allocation of resources from the software and hardware, accurately locate services, and promote the development of medical and nursing services in medical and health institutions.