Study On The System Dynamics Of Integrated Elderly Care And Medical Services Supply In Urban Community Of China

Healthy aging is an important national strategy to protect the rights and interests of the elderly and enable them to enjoy the quality and dignity of life.Integrated elderly care and medical services is the key of healthy aging,the focus and direction of innovating pension mode and coping with the crisis of deep aging,and also a frontier theoretical problem that needs to be answered urgently along with the transformation of research paradigm of public management discipline and the improvement of social security system for the elderly.The establishment and improvement of a high-quality supply system of community integrated elderly care and medical services is an important measure to break through the “last mile” of the integrated elderly care and medical services and improve the health and welfare of elderly groups in grass-roots communities.It not only helps to promote the supply side reform of elderly care services,but also can better respond to the needs of community elderly health care services.Based on the perspective of system theory,this study studies the driving force of the development of community integrated elderly care and medical services,analyzes the dynamic elements in the supply side structural reform of community elderly care,which has academic value for enriching the theoretical framework of social security and promoting related research and development;it also promotes the improvement of social security policy system for the elderly and promotes the high-quality development of elderly services and has practical significance to provide appropriate comprehensive and continuous health services for the elderly in the community.How to improve the driving force of the supply system of urban community integrated elderly care and medical services? The core issue of this study is to find the answer of this question,and make the “integrated elderly care and medical services” better extending to the community and family.Around this research proposition,based on the supply side structural reform theory,system management theory,healthy aging theory,welfare pluralism theory,as well as the operation status and problems of the community integrated elderly care and medical services supply system,this paper establishes the theoretical model and dynamic factor index system of urban community integrated elderly care and medical services supply system.This paper analyzes three subsystems which including resource input,process management and demand satisfaction under the field of environment,and carries out modeling simulation and “policy experiment” by using system dynamics method.The results show that improving the funds has different degrees of impact on the development of human resources of community integrated elderly care and medical services and the improvement of service facilities and equipment.Combined with the improvement of community learning ability and culture identity,the contribution rate of resources will be improved,which will promote the governance level,service quality and demand satisfaction of community integrated elderly care and medical services.The improvement of the coordination degree of multiple subjects and the use of intelligent technology can significantly promote the performance of community integrated elderly care and medical services supply process and the improvement of governance level.Finally,through the improvement of management contribution rate,the elderly in the community can perceive the quality of medical and nursing services.Meanwhile,family doctor contract system,long-term care insurance system,administrative approval system,the level of rule of law have a direct impact on the improvement of the contribution rate of the system,and then have an indirect impact on the improvement of service quality and demand satisfaction;the increase of the monthly income of the elderly in the community and the increase of the coverage rate will affect the utilization of services,and the service utilization and service quality are important to improve the demand satisfaction of the elderly in the community.The research contributuons of this paper can be summarized as three points: First,the innovation of academic thought.The supply of integrated elderly care and medical services should be guided by meeting the actual needs of the elderly,and the structural contradictions in the supply side reform of the service should be considered from a systematic perspective.The key to solve the problem is to clarify the driving force of sustainable development of the service supply system,and improve the coordination degree of multiple subjects participating in the service supply,Only then can we promote the high-quality development of integrated elderly care and medical services in urban communities.Second,the innovation of academic viewpoint.Around the above academic ideas,this paper carries out theoretical research and practical innovation from promoting the supply side structural reform of integrated elderly care and medical services and meeting the needs of community elderly health care services,mainly including: the supply side “three engines” with “factor upgrading,structure optimization and system reform” as the core in the supply side structural reform theory should be in line with important target pull force “demand response”,to build a theoretical model of urban community integrated elderly care and medical services supply system;to establish a dynamic factor index system of urban community integrated elderly care and medical services supply system in two dimensions including four aspects,namely the environmental side of the system reform thrust,the input side of the factor upgrading innovation drive,the process side of structural optimization and transformation,the output side demand response target pull.Third,the innovation of research methods.From the perspective of system theory,this paper introduces the system dynamics method in the field of management science and engineering into the research field of pension service supply,constructs the system dynamics model of urban community integrated elderly care and medical services supply,and puts the complex practical problems into the simplified model.