| The "’The 14th Five-Year Plan’ for the Development of National Aging Career and Senior Care Service System" issued by the State Council proposes to support social forces to build specialized and large-scale elderly institutions with outstanding ability to integrate medical and nursing care,and to play a demonstration and leading role.The setting up of medical institutions within elderly care institutions is a trend of medical care integration,however,the research on the integration of medical and health care in private elderly institutions is not sufficient,and the focus of the academic community on medical and health care services in elderly institutions is mostly on "nursing",and the research on "integration of medical and health care" is not deep enough.Therefore,the research on the integration of medical and health care services provided by private elderly care institutions is of great significance to the development of aging in China.This study focuses on the medical services provided by elderly institutions,and the following questions are studied and answered:What is the current status of the practice of integrating medical care in private elderly institutions?What results have been achieved?What are the challenges in the process of integrating medical and health care practices?What are the reasons for these achievements and challenges?How to better promote the provision of integrated health care services in private elderly care institutions?This paper adopts a qualitative research method and collects materials through observation and semi-structured interviews with managers,medical and nursing staff,nursing staff,elderly people and family members of elderly people in F institutions of private elderly care institutions in Jinan to understand the basic information of the institutions,the way of implementing the integration of medical and nursing care,the supply of elderly care and medical services,the challenges faced during the practice of integration of medical and nursing care and the suggestions of people within the institutions for better development of the practice of integration of medical and nursing care.The study found that the combination of medical care and nursing care implemented by the F institution is "big nursing care+small medical care",which is based on the provision of comprehensive nursing care services for the elderly and the establishment of a medical institution inside the institution,employing specialized medical staff to provide daily monitoring of the elderly’s health condition,medical treatment and medicine dispensing and rehabilitation services,and signing a "medical association construction and medical referral agreement" with neighboring hospitals outside the institution to provide green channel services for the elderly in case of serious diseases.We have signed a "medical association construction and medical care combination referral agreement" with neighboring hospitals to provide green channel services for the elderly to be sent to the hospital in case of serious diseases.However,as a private nursing institution,there are challenges of tight access to medical resources,underutilization of existing internal medical resources,and difficulties in staffing medical and nursing staff compared to other medical and nursing institutions.In response to these problems,this paper explores three aspects:institutional system,resource utilization and medical team,and puts forward suggestions for optimizing the combined medical and nursing care services in private nursing institutions.In terms of institutional system,we should improve the policy synergy mechanism and the synergy mechanism of multiple subjects;in terms of resource utilization,we should play the role of information-based diagnosis and treatment,existing departments and medical association;in terms of medical team,we should strengthen the team building and improve the career development mechanism to realize the transfer and retention of medical talents in nursing institutions. |
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