Study On The Dilemma And Path Optimization Of Social Capital Participating In Medical And Nursing Care Service

With the increasing aging problem in China,the elderly are more in need of daily life care and medical and health services,especially the disabled and semi-disabled elderly.In the case of increasingly strong demand for such compound types,how to integrate limited resources,provide elderly care services combined with medical care,and actively respond to population aging has become a realistic problem.At present,there are three kinds of old-aged care model in China: family support for the aged,community service for the aged and institution endowment,with the development of social economy and the accelerated pace of work and life,family support for the aged function began to weaken,community service for the aged and institution endowment has become a more suitable new choice.The further empowerment of pension institutions,especially the increase of certain medical service ability,the implementation of medical care combined with old-aged care,provides a new alternative for optimizing the existing social old-aged care system.According to the principle of "basic government security and diversified choices provided by the market" and the related concepts and propositions of "new public management theory," China’s government should actively support and guide social capital to participate in the supply of combination of medical care and elderly care,so as to make full use of the successful management methods and strong capital reserves of the private sector,promote the adjustment of the supply structure and the improvement of the supply capacity of old-aged care,optimize the market environment of old-aged care and reduce the financial pressure of the government.At present,there are still many obstacles for social capital to participate in the construction and service supply of medical-nursing combined pension institutions.In this paper,all 40 pension institutions participated in the operation of social capital in H District of Taizhou City are taken as the research objects.Through understanding the current situation of social capital in the operation of medical-nursing combined pension institutions in the region,Combined with macro policy data,the survey data are obtained through field investigation,interview and questionnaire survey,Descriptive analysis,chi-square test,Fisher exact probability method,rank sum test(Kruskal Wallis H)and other methods are used.This paper analyzes various influencing factors of institutions and the public in the supply and selection of old-aged care,discusses from the government,social capital and the public,analyzes the existing problems,and draws the following conclusions: policy subsidies are single and non-long-term;most of the pension institutions’ medical-nursing combined projects are formalistic;the elderly’s hierarchical dynamic management is substantively missing;there are non-capital difficulties in the transformation and upgrading of hardware sites;government departments have multiple supervisions and there are regulatory blind spots;and the instability of policies has a negative impact on the entry of social capital and deep participation in the aged care service market.Finally,based on the new public management theory and principal-agent theory,this paper puts forward some countermeasures and suggestions to improve the social capital participation in the construction and service supply of medical-nursing combined pension institutions.