1 "big old age + small medical" type
This model is to build a new small medical institution on the basis of the old age institutions, new medical services, with the old age as the main, medical care as a supplement. At present, most of the nursing institutions to take this model to carry out health care services. The model has obvious shortcomings: the built-in medical institutions can only carry out outpatient business, can not solve the problem of direct hospitalization in the nursing home; at the same time, the high operating costs of medical institutions, only the salary of medical staff to the nursing home has brought a great burden, nursing home difficult to support long-term.
Many have applied for a built-in medical institutions for the elderly, medical institutions for a period of time within the trial run can not continue to adhere to the "people away from the building".
2 "medical, nursing and" type
This model is mostly for the new health care institutions or hospitals transformed into nursing homes or nursing homes, emphasizing the development of both medical and nursing. New large-scale nursing institutions, supporting the construction of integrated hospitals or nursing homes, to achieve the development of medical and nursing; some of the idle resources of the medical institutions will be surplus resources for the transformation of nursing services, in order to open the special care wards for the elderly or directly transformed into a nursing home, rehabilitation centers, etc. to provide medical and nursing care services.
This model integrates medical and nursing resources to form an operational situation where medical care promotes nursing and nursing helps medical care, and can basically realize the enjoyment of non-critically ill elderly people with medical care **** in the institution.
3 "big medical + small pension" type
This model is mostly a larger medical institutions to build a new small pension institutions, through the provision of related facilities, increase nursing staff and other initiatives, in the medical institutions within the hospital and a new hospital under the professional pension institutions.
This model is the use of high-end medical resources to build nursing institutions, the advantages of good conditions of the nursing environment, good medical care, more high-end, but there are obvious shortcomings: on the one hand, the use of existing hospital resources is not economic or even wasteful, on the other hand, the cost of old age is higher, the economic conditions of the middle and lower levels of the average family can hardly afford.
4 "big medical + small rehabilitation" type
This model is mostly larger medical institutions to build new small rehabilitation institutions, such as geriatrics or rehabilitation, rehabilitation centers, medical care as the main, rehabilitation as a supplement, most of the original medical institutions in the new rehabilitation, care functions, to build a medical, care, rehabilitation and other interconnected service system.
Most of the development of this model is better, but in the "medical, recreation and health care integration" system, the proportion of "health care" is smaller.
5 "two hospitals as one" type
This model is mostly the local government to build the elderly homes by the local township health center trusteeship operation, township health centers and elderly homes to realize the "integration", or by the township health centers directly to build a new The township health center and the home for the aged are "integrated", or the township health center directly builds a new home for the aged in order to realize the integration of medical care. Township health centers utilize the resources of the homes for the aged to take care of the "five guarantees for the elderly," but also accept a portion of the social pensioners. This model is an effective integration of existing pension and medical resources, can activate the supply of medical resources gravity, close to the service of rural elderly people, to help them realize the local old age.
Compared with the "public-private" pension services, the model is easy to maintain the value of the original state-owned assets of the elderly homes, is a more ideal model of health care integration.
6 "medical health care" type
In the hospital based on the new nursing home and nursing home, the implementation of medical, health, nursing integrated operation. The advantage of this model is that rehabilitation patients hospitalized for some time, the physical condition is greatly improved, many patients from bedridden to walk independently, the social benefits are excellent; rehabilitation patients during hospitalization both rehabilitation treatment services, but also pension services, rehabilitation and discharge may be a group of people in the nursing home long-term stay, the economic benefits of the institution will be greatly improved, is the most efficient allocation of resources in the combination of medical care model. .
7 "individual clinic + small pension" type
This model is generally organized by individual clinics, the front foyer for the clinic, the back of the family-type small pension, clinic doctors, nurses to provide medical care for the elderly, and the other hired 1-2 nursing staff to take care of the elderly.
The advantages of this model are low fees, close to home, more convenient, full utilization of resources, good results; but the disadvantage is that the medical and nursing facilities are relatively simple, the care is not standardized, while there is also the problem of uneconomical scale.
8 "elderly institutions + medical services overall outsourcing" type
This model refers to the elderly institutions do not have the conditions to set up medical institutions, and the nearest medical institutions with inpatient function (mostly medical institutions (mostly first-class general hospitals) signed a cooperation agreement, the elderly institutions required medical services overall Outsourcing of the medical services required by the nursing home to the medical institution, the nursing home to provide premises and necessary conditions for the medical institution, the medical institution in the nursing home to set up branches, such as branch hospitals, the medical institution to send medical staff to the nursing home for the provision of medical services outsourced as a whole, or "the overall trusteeship of the nursing home's health care services". The advantage of this model is that the two sides of the medical care responsibilities, rights, and benefits are clear, both sides use the market mechanism to carry out cooperation.
This is a professional division of labor and cooperation between medical and nursing, improve the efficiency of resource utilization in an effective form, especially for 100-300 people in the elderly institutions to carry out medical and nursing services (smaller elderly institutions to use this model, the medical institutions may "lose money" resulting in unsustainable services, the need for elderly institutions to give some subsidies to the medical institutions). (Smaller nursing institutions using this model may "lose money" resulting in unsustainable services, requiring nursing institutions to give some subsidies to medical institutions).
9 "Pension institutions + medical services green channel" type
This model refers to the elderly institutions and neighboring medical institutions signed a cooperation agreement, medical institutions for the elderly institutions to provide patients with a "green channel" for medical treatment, priority to provide Hospitalization, remote consultation, appointment booking and other services, which is currently the province to carry out the most of a model of medical integration. The shortcomings of the model is: medical institutions and nursing institutions based on cooperation from the two sides of the trust and interest-driven cooperation between the two sides of the lack of effective constraints and interests of the coordination mechanism, once the agreement affects the interests of a party, it is easy to terminate the agreement, it is difficult to ensure that the effectiveness of the cooperation, continuity.
This model is difficult to realize the integration of medical care, basically belongs to the "form", it is difficult to carry out substantive cooperation between the medical care, basically each do their own (such as nursing institutions have patients need hospitalization, although the agreement requires priority to the cooperation of the medical institutions hospitalized, but the patient's family does not necessarily agree, may go to a larger scale, More assured hospital), over time, it is difficult to long-term cooperation.
10 "big old age + small medical + medical services green channel" type
This model is the elderly care institutions themselves first build a small medical institutions, such as health room or clinic, and at the same time another with other larger medical institutions signed a cooperation agreement, and by the elderly care institutions to provide patients with a medical treatment The "green channel". For general medical problems, the nursing institutions solve the problems themselves, and when there are more serious patients are immediately transferred to the cooperating medical institutions for consultation and treatment.
The above ten "institutionalized elderly" medical service mode, the first seven for the "integrated" mode, the eighth and ninth for the "embedded", the tenth for the "hybrid". The eighth and ninth are "embedded" and the tenth is "hybrid". The first eight kinds of medical and nursing combination is relatively tight, the ninth for the loose combination of medical and nursing, the tenth for the half-loose half-tight.
Currently, when the relevant departments present their achievements, the coverage rate of medical and nursing care has reached a certain number, but the loose model of signing agreements is often the most common.
We believe that the loose model is basically a "form of engagement", medical institutions and nursing institutions are difficult to substantive cooperation, and even more difficult to market-oriented operation; the combination of health care must be used in an "integrated" development model.
11 "community health service institutions + day care centers for the elderly" type
Day care center facilities can be in the elderly, medical care, basic public **** health services and other aspects of **** enjoy the use of resource allocation efficiency; generally sent to the "day care centers for the elderly", "the elderly", "the elderly", "the elderly", "the elderly", "the elderly", "the elderly", "the elderly", "the elderly", "the elderly" and "the elderly". Day care centers for the elderly, most of the people, "one more than one disease", these people need more medical personnel to provide services, so this model can more to meet the medical needs of the elderly; at the same time, only the medical staff to undertake the corresponding services, the children of the elderly can be more assured that they can be more elderly people to the day care centers for the elderly. The elderly day care centers.
Community health service institutions are entities, the operation of day care centers for the elderly, in line with the requirements of "can be responsible and accountable", and the separation of ownership and operation, not only solved the management and operation of the day care centers for the elderly by the community board of management and operation of the system, the ownership of the unclear, but also solved the day care centers for the elderly assets unused. Day care centers for the elderly, the problem of idle assets, but also to resolve the tension of community health service institutions, the realization of the contradiction in the use of resources *** enjoy; not only can reap the social benefits of "better protection of health care for the elderly, the elderly children more at ease," and so on, but also through more services for the community health service institutions to bring due economic benefits, and at the same time, can also promote the industrialization of the elderly, really It can also promote the industrialization of old age, truly realize multi-***win, is the ideal way to realize the combination of health care at the community level.
12 "community health care facilities *** build *** enjoy" type
The elderly service facilities with primary health care service institutions unified planning, unified construction, such as rural homes and health room construction, urban community day care center and community health service institutions synchronization construction. Through the synchronization of construction, one step to achieve the community level of health care integration.
13 "professional elderly care operators + day care centers for the elderly" type
The day care centers for the elderly are hosted by large professional elderly care institutions, which make full use of the idle resources of the day care centers for the elderly. The research found that this model due to the small size of the elderly day care centers (generally only 10 beds), it is difficult to play the economies of scale; at the same time, some professional elderly care institutions can not keep up with the medical services, it is difficult to do a good combination of health care, once the government subsidies are reduced or canceled, it is difficult to maintain.
14 "community integrated nursing service institutions and community health service institutions signed an agreement" type
This model is often the community to build a comprehensive service center for the elderly, in order to carry out the combination of medical care and community health service institutions signed a cooperation agreement, but the services carried out are mainly basic public **** health services, basic medical services are relatively few. services, and relatively few basic medical services.
15 "Village Health Office + Rural Well-being Home" type
The village health office hosts and operates the rural wellbeing home, realizing the combination of medical care at the rural community level, but there are not many typical cases at present.
16 "Internet+Wearable Devices+Physical Service Institutions"
This model requires equipping the elderly at home with wearable devices to remotely monitor their living and physical conditions, and through information management platforms and the use of the Internet and Internet of Things, the data related to the elderly's daily life, health and travel conditions can be transmitted to the elderly in a timely manner. Through the information management platform and the use of Internet of things, the data related to the elderly in daily life, health and travel situation are timely transmitted to the entity medical and nursing care institutions or entity community institutions (such as nursing stations, community health service organizations) and the children of the elderly; the entity service organizations make service programs based on the data of monitoring the body of the elderly, and at the same time, according to the needs of the elderly and their children, provide timely services related to the elderly at home such as diet, medical care, fire safety and security, recreation, alarm, call for help and so on. The service is also provided in a timely manner according to the needs of the elderly and their children.
At present, many companies are keen to develop this model, and some are designed on a larger scale, but there are not many successful cases at present.
17 "home care + family doctor contracting service" type
This model is to promote family doctor service by carrying out family doctor contracting service activities, signing service agreements with elderly residents in need, and carrying out contractual services, so that contracted objects can obtain medical care provided by family doctors, counseling services, quality diagnostic and treatment services, and precise and accurate diagnostic services. consulting services, high-quality diagnosis and treatment services, precise appointment referral services, health care guidance, disease intervention, family beds, health management and other services, so that the elderly can enjoy medical services, basic public **** health services and personalized health management services provided by high-quality medical resources at home.
This model mainly solves the problem of medical services for the elderly living at home, but the socialized living services are not effectively solved, and we believe that this model is not a substantial combination of medical care and health care, and still belongs to the category of basic public **** health services.
18 "home care + long term care insurance in the 'home care' services" type
This model is to provide home care services for eligible elderly people with disabilities, the elderly people with disabilities in their homes by their own family members to provide life care, by the long term care insurance designated medical institutions. The designated medical institutions of the long-term care insurance provide "home care" services focusing on rehabilitation, and the relevant costs are mainly funded by medical insurance. This home care model is currently mainly for urban workers who enjoy long-term care insurance, although popular with residents, but the social cost is very high, and medical staff to and from the medical institutions and residents at home time cost is also very high, and the elderly with disabilities in nursing homes, compared to the "home care" resource allocation efficiency is not good.
Additionally, the research also found that some large-scale organizations combining medical care in the good "institutional care" at the same time to "community care" and "home care" to provide extended services in the "institutional care" and "home care". They provide extended services to "community care" and "home care", and carry out medical and nursing services at the three levels of "institutional care", "community care" and "home care" simultaneously, forming the "institutional care", "community care" and "home care" levels of integrated development, The "community, home three levels of integration and development of intelligent" medical care combination model, economic and social benefits are better.
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Source: Greenblue Travel, Copyright ? 2012 by the original author, if there is any infringement, please inform the background.
Originally titled: "Recreation | Medical care combination of 18 models are what?