Entering an aging society, with the increasing number of chronic non-communicable diseases, implementing the health management strategy for the elderly, using limited resources to maximize the quality of life of the elderly and reduce the social burden, is an important breakthrough in developing the aging industry and a strategic choice to meet the challenges of aging at low cost. The following is an article about the health management service model of the elderly. Welcome to read!
First, attach importance to the health management of the elderly and promote the sustainable development of society.
In our country, suffering from chronic diseases has shown? Blowout? Phenomenon, which also produces high medical expenses, making it the number one public enemy of health. The elderly are the main group of patients with chronic diseases, and more than half of the elderly in China suffer from chronic diseases such as hypertension, cerebrovascular disease and diabetes (National Health and Family Planning Commission, 20 13). In order to reduce the economic burden of society and families, rationally allocate and make full use of resources, and promote the sustainable development of society, the elderly should be regarded as the first group of health management. Only do a good job in the health management of the elderly; Only in this way, healthy elderly people can maintain good living habits and promote health. Older people at risk of illness can change their lifestyles and prevent the occurrence of diseases. Sick people can control the disease process and prevent disability, and can promote the functional recovery of rehabilitation patients, improve their quality of life and prolong their lives. In short, the health management of the elderly population should be as important as the health management of children aged 0-6 and pregnant women.
Second, relying on the old-age service system, the focus of health management for the elderly will sink to the community and family.
At present, China is building an old-age service system based on home, supported by community and supported by institutions. The health management service for the elderly should rely on the old-age service system and focus on the community and family.
(A) relying on the community to establish a relatively independent health management center for the elderly.
Community is a grass-roots organization closely related to people's lives. Therefore, the implementation of health management for the elderly should rely on the community. At present, the health management of the elderly in China is mainly undertaken by community health service institutions. As the two key contents of community health services, the lack of effective linking mechanism between basic medical care and basic public health services in China, coupled with the shortage of medical resources and professionals, makes the current community health management system for the elderly unsustainable. It is suggested that each community should establish a relatively independent elderly health management center. The management center is not attached to the existing medical institutions, nor is it for profit; Instead, it is set up by the government, giving it special financial support, and providing it with basic health check-up equipment and an appropriate number of health management personnel separately to maintain its public welfare nature. The community elderly health management center is responsible for coordinating the pension and medical resources of community health service institutions, community elderly care centers and other organizations, and carrying out the health management of the elderly in this community, which will reduce the incidence of chronic diseases and medical expenses of the elderly in this community as assessment indicators, and further enhance the ability of community health services.
(2) based on the family, establish? Everyone is involved? Health mutual aid group for the elderly
With the aggravation of the aging process of the population, it is no longer possible to support more and more elderly groups by relying solely on the health management of the elderly by the community and health managers. It is imperative to build a community-based family health management model. In recent years? Chaoyang people? The advanced deeds and rapid popularization of square dance further prove that the spontaneous strength of the people is very great. The health management center can call on the elderly in the community to set up a number of health mutual aid groups with residential units as units, and the members of the groups elect the elderly with healthy lifestyles, less risk of chronic diseases and full of energy as team leaders. The community health administrator is responsible for guiding the team leader, who is responsible for urging the team members to have a balanced diet, adhere to moderate exercise and maintain a healthy lifestyle. Through the form of group activities for the elderly, we should carry out self-help and mutual rescue, strengthen healthy self-management, give play to the peer effect, and rely on the strength of the elderly group to form? Everyone is involved? Types of health management mode.
(3) for institutions and promotion? Medical, nursing, nursing? Combined service mode
As a supplement to home care and community care, institutional care mainly accepts the disabled, semi-disabled, demented and other elderly people with difficulties in home care and community care. Should the health management of the elderly in the old-age care institutions pass? Medical, nursing, nursing? Combined with service mode. ? Medical, nursing, nursing? The combined service model is not a simple addition of nursing homes and hospitals, but a combination of medical resources and old-age resources. Through health management, the elderly in institutions can enjoy health assessment, establishment of health files, lifestyle management, emotional comfort, chronic disease prevention, health promotion, rehabilitation care, life care, hospice care and other services. By integrating existing resources, some medical institutions can be encouraged to transform into nursing homes or rehabilitation institutions for the elderly, and they can also be realized through independent setting, supporting facilities or agreement cooperation, so that the old-age care institutions have medical conditions. Push? Medical, nursing, nursing? Combined with the service model, it needs the cooperation of civil affairs departments and health departments, and also involves many problems such as the establishment of medical insurance system and long-term care insurance system. Therefore, it will take time for it to really land.
Third, manage chronic diseases at different levels and according to different diseases, and attach importance to the rehabilitation training of daily life and the application of assistive devices for the demented and disabled elderly.
In China, because more than half of the elderly suffer from various chronic non-communicable diseases, the main content of health management services for the elderly is chronic health management; In addition, it also includes the rehabilitation of self-care ability of disabled and demented elderly people and the research and development of assistive devices.
(a) to carry out chronic disease management at different levels, according to the disease, reduce the prevalence of chronic diseases, reduce complications.
According to the statistics of the World Health Organization,13 of chronic diseases can be avoided through preventive health care,13 can be effectively controlled through early detection, and13 can improve the treatment effect through early intervention. Through physical examination and health assessment, the elderly were divided into general population, high-risk population with different diseases and sick population (Du Lijun et al., 20 14). Through this hierarchical and disease-specific chronic disease management, the prevalence of chronic diseases can be reduced and complications can be reduced, which is an effective measure to control chronic diseases. According to the high incidence of hypertension, diabetes, cardiovascular and cerebrovascular diseases, we can carry out disease management and take personalized health intervention measures. Measures such as health education and lifestyle management are mainly taken to improve the health awareness of healthy people who have not yet got sick and reduce the risk of illness. For the sick people, measures such as health education and lifestyle management should be taken to prevent or delay the development of the disease, and different treatment and disease management measures should be taken according to the development process of the disease to reduce complications and prevent injury or disability due to illness.
(2) Pay attention to daily life rehabilitation training and the use of assistive devices to improve the prognosis of chronic diseases and improve the quality of life of patients.
For the elderly suffering from cardiovascular and cerebrovascular diseases, Alzheimer's disease and other chronic diseases, in addition to providing them with life care services, their health management should also pay attention to daily life rehabilitation training and the use of assistive devices. Rehabilitation training of daily life can be carried out according to different types of obstacles such as movement, eating, grooming, dressing, bathing, going to the toilet and housework. Assistance includes rehabilitation training, self-care and protection, personal mobility, household management and environmental improvement. Through daily life rehabilitation training and the use of assistive devices, we can help the elderly to recover their physical functions, maximize their physical potential, make the elderly have better adaptability to life, prevent the loss of physical activity function, improve the prognosis of diseases and improve the quality of life.
Fourth, increase investment, implement policies and promote the construction of relevant laws, systems and standards.
(a) the government led, increase investment to ensure the fairness of basic health management services.
Children aged 0-6 in China have established health care manuals since their newborns, and enjoy free health management services such as disease screening, physical examination, growth and development assessment, family visits and vaccination. Pregnant women enjoy maternity insurance, establish early pregnancy health care manuals, and enjoy various health management services such as health assessment, prenatal examination, health education, family visits, and postpartum review. The health management of the elderly belongs to the field of public health services, and should be paid equal attention to with the health management of children aged 0-6 and pregnant women. However, due to the lack of sufficient special funds, public health service institutions are busy developing medical services with economic benefits, but lack enthusiasm for health management services that cannot be included in the scope of medical insurance reimbursement and provided free of charge for the elderly (Justin et al., 20 1 1). In this context, high-end health management companies with small numbers and high fees have rushed to the market in this field.
Health management of the elderly population also belongs to the field of public health services, and organizations or institutions that provide basic health management services for the elderly population should be independent of existing health service institutions. Because of the public welfare nature of health management for the elderly, these organizations or institutions should not adopt the business operation management mode of enterprises, nor should they aim at making profits. In order to improve the quality of life of the elderly as a whole, the health management of the elderly should be raised to the national strategic level. The government should set up a relatively independent health management center for the elderly, adhere to the government's leadership, integrate various resources such as medical care and old-age care with the concept of health management, and give special funds to support and further increase investment. In order to solve the problem of funding sources through multiple channels, special health management funds and insurance products for the elderly can be set up, or health management for the elderly can be included in medical insurance. In short, the health management of the elderly should be as practical as children aged 0-6 and pregnant women, so that every urban and rural elderly can enjoy free health screening, health assessment, establishment of health files, chronic disease management, health education and health promotion, and ensure the fairness of their basic health management services.
(2) Implement policies to promote the construction of laws, systems and standards related to health management of the elderly.
At present, the institutions that carry out health management services for the elderly in China are mainly composed of relevant departments of hospitals at all levels, community health service institutions and various physical examination centers that treat elderly patients with chronic diseases. Due to the lack of relevant laws, systems and standards, the existing health management service institutions are mixed and the professional service level is poor. The service content is mostly limited to general physical examination and symptom control of various chronic diseases. Nip in the bud? The concept of prevention first and the health management of chronic diseases have not been well implemented.
In 20 13, the State Council issued two documents concerning the health management service for the elderly, namely, Several Opinions on Accelerating the Development of the Aged Care Service (Guo Fa [2013] No.35) and Several Opinions on Promoting the Development of the Health Service Industry (Guo Fa [2013] No.40), and proposed to promote the health management service for the elderly. Among them, some opinions on promoting the development of health service industry? Policy measures? Article 6 clearly puts forward that it is necessary to improve the laws, standards and supervision of health services, including promoting the formulation and revision of relevant laws and administrative regulations to promote the development of health services, standardizing service behavior, improving the service quality and service level as the core, improving the service standard system, strengthening the implementation of standards and improving the standardization level of health services.
Governments at the provincial, city and county levels, as well as civil affairs and health departments, should, according to the actual needs and work of the local elderly population health management, promote the implementation of policies, accelerate the establishment of health management service licenses for the elderly population, introduce relevant industry standards, formulate service processes, standardize service behaviors, strengthen supervision and management, and promote the long-term, sustained, stable and healthy development of health management services for the elderly population.
Fifth, speed up information construction and innovate a new model of intelligent health management for the elderly.
(a) to speed up the construction of information technology, the establishment of standardized and accessible electronic health records.
Informatization construction is the development trend of health management. In the case of limited human and material resources, in order to promote the sustainable development of health management services for the elderly, it is necessary to speed up information construction, give full play to the advantages of information technology such as high efficiency, rich content and intelligent service, and make full use of information technology to establish standardized and accessible electronic health records (Huang Yidong, 20 14). The association of health record information with electronic medical records of medical institutions, household registration management information of public security system, social insurance, medical insurance and other information provides convenience for the preservation, tracking, updating, sharing and analysis of health information of the elderly, thus realizing health management in different places and making it possible to monitor and manage individual health in a lifelong system.
(B) Internet of Things technology to promote the elderly intelligent health management innovation model
Internet of things technology is one of the emerging strategic industries in China. For the health management of the elderly with chronic disease management as the main content, the application space of this technology is particularly broad (Huang Yidong, 20 14). Driven by Internet of Things technology and based on telemedicine platform, health management module can be better embedded in telemedicine and hospital information management system, so as to extend systematic health management and telemedicine to communities and families and explore a brand-new sustainable, seamless and intelligent health management model for the elderly.
Wireless sensor networks based on Internet of Things technology can play a prominent role in monitoring human physiological data, health status, telemedicine and so on (Zhang Dongni et al., 20 13). Wearable devices, for example, have developed from initial exercise monitoring to dynamic monitoring of physiological indicators such as blood pressure, blood sugar and oxygen saturation. In the future, the elderly may not need to go to health management centers and medical institutions often, but only need to complete simple routine monitoring at home. At the same time, health data can be updated in real time and dynamic monitoring can be strengthened through various means such as health management information platform and mobile phone software. Community health management centers and medical institutions connected through the network can obtain the health information of the elderly in time; Through health management software, we can screen the risk factors of diseases, quickly judge the condition, and decide whether to carry out lifestyle intervention, remote treatment, disease control or arrange them to go to the hospital according to the severity of the condition.
Six, the construction of professional service team, promote medical staff to practice more.
(1) Establish a long-term incentive mechanism and build a professional service team.
The training of professional service personnel and team building are the key to the health management of the elderly. It is necessary to build an elderly health management service team (Zang, 20 13) composed of community elderly health managers, community elderly nurses, community family doctors, community elderly workers, clinicians in tertiary hospitals, Chinese medicine and other professionals. Establish a talent introduction mechanism that conforms to the professional characteristics of community elderly health management services, build a salary assessment system with the number of elderly people served, service quality and service satisfaction as the main indicators, form a long-term incentive mechanism, give more training opportunities and career development space, and make community elderly health management services attractive to outstanding talents.
(two) to promote the practice of medical personnel, improve the quality of community health management services.
Opening up and promoting the practice of medical professionals will help to make up the gap between community health management service departments and primary medical institutions, thus improving the quality of community health management services. In addition to the elderly health managers, other professionals in the community elderly health management service team can consider being supplemented by medical personnel who practice at multiple points. Through the incentive mechanism, the medical staff of tertiary hospitals with multi-point qualification will be attracted to take community health service institutions as one of their practice places. These medical staff can guide the work of community health managers and participate in health management services such as chronic disease management and lifestyle intervention for the elderly in the community, thus improving the quality of community health management services.
In a word, to achieve vigorous aging, we must attach importance to the health management of the elderly. We should focus on the community and family, and establish a relatively independent elderly health management center in the community. Everyone is involved? Health mutual aid group, promotion organization? Medical, nursing, nursing? Combined with service mode; Adopt a hierarchical and disease-based chronic disease management model, pay attention to the daily life rehabilitation training and the application of assistive devices for senile dementia and disabled elderly people, reduce the prevalence of chronic diseases, reduce complications, improve the prognosis of chronic diseases and improve the quality of life; Government departments should give special funds to support the health management of the elderly, increase investment and promote the construction of relevant laws, systems and standards; Accelerate information construction, establish standardized and accessible electronic health records, and innovate a new model of intelligent health management for the elderly; Establish a professional service team to promote medical staff to practice more and improve the quality of health management services for the elderly in the community.
;