On The Function Mechanism Of Government Behavior On The Development Of Integrated Medical And Nursing Services

Population aging has become one of the main social problems faced by all countries in the world,and China is no exception.According to the data of the seventh national census bulletin,as of November 1,2020,China’s total population was 1.41 billion,including 190 million elderly people aged 65 and over,accounting for 13.5% of the total population.It can be seen that China has been in an aging society.With the development of China’s economy and society,the average life expectancy of the population is also increasing,followed by the aging,empty nest and higher prevalence of chronic diseases,and the accompanying problems are becoming more and more prominent.At the same time,the needs of the elderly for life care,medical rehabilitation and other aspects and levels are also increasing,which requires the development of high-quality elderly care services combined with medical care.The relevant national policy documents describe this elderly care service model as "combined medical care and elderly care service",which is essentially an elderly care service that integrates medical resources and elderly care resources belonging to different public service systems in order to provide continuous and comprehensive medical care and life care for the elderly.Its ultimate goal is to achieve healthy aging.As a pension service model aimed at effectively solving the urgent needs of the elderly,the government should play a leading role.It is a complex process of administrative activities to build an old-age service system based on home,supported by community,supplemented by institutions and combined with medical care,and promote its healthy and orderly development.The existing theories,literature and relevant practical experience show that the factors affecting the development of integrated medical and nursing services are complex,and the role of government behavior needs to be further observed and demonstrated.In addition,the academic and practical research on the integrated medical care service focuses on discriminating the concept,discussing the mode selection and proposing the optimization path,while the research on the related government behavior is relatively less,lacking the systematic observation and inspection of the influencing factors and function mechanism in the development of the integrated medical care service from the perspective of government behavior.Therefore,studying the function mechanism of government behavior on the development of integrated medical and nursing services is not only of great significance for improving the elderly care service system and improving the quality of life of the elderly,but also helps to improve the government governance ability,and provides positive and beneficial experience for promoting the modernization of national governance system and governance ability and building a service-oriented government satisfactory to the peopleOn the basis of theoretical combing and practical experience summary,this paper discusses the influencing factors and function mechanism of government behavior on the development of integrated medical care services by constructing and testing the theoretical model.Specifically,it focuses on "what are the government behavior factors affecting the development of integrated medical care services?" "Through which paths do these government behavior factors affect the development of integrated medical care services?" "How to optimize government behavior and promote the development of integrated medical care services?" And other three main problems,which run through the research main line of "literature review-Model Construction-Empirical Analysis-Case Study-strategy selection",and strive to achieve the following innovations,that is,to expand the dimension of influencing factors of government behavior in the development of integrated medical care services;Build and verify the model of the mechanism of government behavior on the development of integrated medical and nursing services;Enrich the existing research methods on the impact of government behavior on the development of integrated medical care services.It mainly includes the following aspects:Firstly,identify the influencing factors of government behavior and construct the theoretical model of the function mechanism of government behavior on the development of integrated medical care services.Based on the idea and technology of grounded theoretical analysis method,this paper systematically codes the theoretical literature and typical cases,analyzes the connotation and extension of "the development of integrated medical care services",analyzes the government behavior factors that may affect the development of integrated medical care services,and constructs the theoretical model of the function mechanism of government behavior on the development of integrated medical care services.The research shows that the factors affecting the integrated medical care service include internal government behavior,external government behavior and government trust.Among them,internal government behavior includes organizational leadership behavior and departmental coordination behavior;External government behavior includes system supporting behavior,service supervision behavior,guiding participation behavior and education propaganda behavior.The development of integrated medical and nursing services also includes two important indicators: the improvement of institutional service quality and the improvement of elderly satisfaction.At the same time,based on the theoretical model,the corresponding research hypotheses are put forward.Secondly,the theoretical model and the hypotheses are tested through empirical analysis.This study conducted a questionnaire survey on the heads of medical and nursing service institutions and the elderly receiving services,and used the questionnaire survey data to verify the research hypotheses proposed according to the theoretical model.The research shows that internal government behavior,external government behavior and government trust are positively correlated with the development of integrated medical care services.Government trust has an intermediary effect between internal government behavior,external government behavior and the development of integrated medical care services.Internal government behavior and external government behavior can not only indirectly affect the development of integrated medical care services through government trust,but also directly affect the development of integrated medical care services.Thirdly,through the analysis of typical cases,it further confirms the research hypothesis and points out the direction for the optimization strategy of government behavior.Using the theoretical point of view and case description analysis,this paper selects two typical cases of combined medical care service for discussion,and interviews the heads of service institutions,government staff and the elderly respectively.Through case analysis and interviews,it can be seen that government behavior and government trust such as organizational leadership,departmental coordination,system matching,service supervision,guidance and participation,education and publicity are the main factors affecting the development of integrated medical care services,which verifies the empirical part.At the same time,based on multi-party interviews,it is found that in the specific practice of integrated medical and nursing services,the government behavior still needs to be improved,which points out the direction for developing optimization strategies.Finally,optimize government behavior to promote the development of integrated medical care services.This paper mainly optimizes government behavior from the following aspects: first,further strengthen organizational leadership behavior by formulating scientific planning and clarifying government responsibilities;Second,the effective coordination function mechanism,inter department performance coordination function mechanism and responsibility sharing function mechanism are used to improve the department coordination behavior;Third,establish the access and service standardization system of service institutions,the needs and health assessment system of the elderly,implement the long-term care insurance system for the elderly and the talent training system of integrated medical and nursing services,so as to provide institutional guarantee for the development of integrated medical and nursing services;Fourth,strengthen the service supervision behavior by strengthening the learning of government regulation and building a collaborative supervision function mechanism,which can promote the improvement of the service quality of the combination of medical care and nursing;Fifth,improve and broaden service financing channels,cultivate the ability of social forces and the construction of enabling wisdom platform,and promote social forces to actively participate in the integrated medical and nursing services;Sixth,strengthen policy publicity and promote the concept of "active health" to further improve education and publicity.Seventh,the government enhances public trust in the government by improving government performance and strengthening political and social interaction.