Research On The Optimization Of The Policy Network Of Integrated Elderly Care And Medical Services For The Elderly

China is entering the aging stage rapidly,and aging shows the characteristics of a large base,a large number of disabled and semi-disabled elderly,and a large demand for elderly care.The original family pension model can no longer meet the current pension market,and the original resource fragmentation is no longer suitable for the current needs of the elderly for pension resources.In view of the current status of elderly care,the State Council issued the "Opinions on Accelerating the Development of the Elderly Care Service Industry"(hereinafter referred to as the "Opinions")in 2013,and for the first time proposed the concept of "integration of medical care and elderly care".Under the guidance of the central macro policy,all localities formulate and implement relevant policies for the integration of medical and elderly care.As one of the most developed cities in my country,with the support of a good economic environment and policy environment,Shanghai has achieved good results in the development of integrated medical and elderly care services,and has formed a representative community integrated medical and elderly care service model.As a national pilot city for the integration of medical and elderly care and a typical experience city for the integration of medical and elderly care in the country,Shanghai’s integrated medical and elderly care services are representative.Since there are few related researches on the optimization of the policy network for the integration of medical and elderly care,a single case study can better grasp the details of the research and conduct a more comprehensive and in-depth study of related issues.Therefore,this article uses a single case study method to sort out the types of actors in the process of Shanghai’s medical-care integration policy from the perspective of the policy network,and analyzes the medical-care integration policy network from both static and dynamic dimensions.Propose optimization strategies from the perspective of network governance.This article attempts to answer the following questions:(1)What is the current status of the central government and the Shanghai Municipality’s policy on the integration of medical and elderly care? Who are the actors in the policy network of integrated medical and elderly care services? What role does each play?(2)Based on Van Woden’s definition of the policy network structure,from a static point of view,what are the structural characteristics of the policy network of integrated medical care and elderly care services?(3)From a dynamic perspective,it analyzes how the actors interact within the policy network of integrated medical care and elderly care services? How do actors interact?(4)What are the problems in the interactive process of the policy network for the integrated medical care and elderly care services? How to optimize from the perspective of policy network governance?Based on the policy network theory,this article uses Shanghai as a single case study to analyze the policy network of integrated medical care and elderly care services,and draws the following conclusions:(1)There are many types of network actors in the policy network for the integration of medical and elderly care;Multiple interaction relationships are formed within and between actors based on their resource dependence.(2)There are problems of unequal status,low openness,and low network cohesion among policy network actors.(3)The medical-care integration policy relies too much on the promotion of the policy community and the intergovernmental network,and other types of policy actors passively accept it,and it has not formed a situation of orderly and smooth actions.Aiming at the structural characteristics of the integrated medical care and elderly care policy network,combined with the existing problems in the Shanghai integrated medical care and elderly policy network,the following optimization countermeasures for the integrated medical care and elderly care service policy network are proposed from within and among the actors of the policy network.Within the policy network actors:(1)Strengthen the status of marginal actors and form in-depth participation relationships;(2)Attract more actors to participate and form an open policy environment;(3)Strengthen the internal cohesion of actors and form smooth coordination mechanism.Between policy networks:(1)Arousing the enthusiasm of participants and increasing the degree of network openness;(2)increase the voice of the issue network actors;(3)Properly adjust the interaction of policy network participants.