2013，The State Council issued the "Several Opinions on Accelerating the Development of Pension Service Industry" (Guo Fa [2013] No. 35)，This opinion clearly proposes "Actively Promote the combination of medical and health and pension services，Promote the Development of ‘Medical and Nursing Integration’ ”。2015，"Notice on Promoting the Guidance Opinions of Promoting Medical and Health and Pension Services" (National Office [2015] No. 84) further explaining the combination of medical care。This can be seen，The combination of medical care and care has become an important measure to deal with aging society in my country。Sort out the existing experience at home and abroad，Help promotes the development of the combination of medical care in my country。

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"Integration Service" rose in the 1960s，The purpose is to connect relevant groups and fragmented services through reforms，Establish an effective service network，Be better to meet the needs of the service object。The 2080s，The British government began to go to the hospital to find chemical、Destroyer、Reform of administrativeization，Actively mobilize all the old service resources in the community，Integrated formal care and informal care forces，Help and promote the normalized life of the caring person in the community。

2016，I made a special trip to visit the small city of Brighton, UK。Brighton has established a integrated care service center，The core attention point of the agency is how to meet the needs of residents，Person people as a whole，instead of different problems faced by different departments。Bet365 app download It is committed to solving problems that people really need to solve，and find out the real social cause behind the disease (such as housing、care、Poverty、Social relationship dilemma)，Use community resources to try to solve these problems，Let people live independently at home。This concept has driven the change of the work method。Integrated care service center has designed 7 areas based on the distribution of the city's clinic，A care manager and 2 general doctors are set up in each area。Care manager in the region to deeply find the medical care needs of the elderly in the region，After verification with the general doctor, the verification of the general doctor to the residents。After the resident himself is confirmed，Care managers will organize joint meetings in the region，The meeting is by the pharmacist of the region、Health care guidance、Social worker、General Doctor、Local housing security personnel, etc.。They discuss the needs of residents，Find the possible social reasons behind the needs of health and propose a solution。then，They discuss the solution with the residents themselves，and implement it after obtaining the consent。The plan includes improvement in health care (such as installing prosthetic limbs)，It also includes improving the living structure、Suggestions and actions to improve social relations。The person in charge of the institution Mark Cannon said，The integration working method implemented now contains a lot of changes，This change is a major change in the thinking mode of the British Health Service (NHS)。This means that the object of the elderly service is an overall，instead of the "combination of parts" responsible for different departments。

Integrity，There are four connotations of the integrated care service model of developed countries。2，Integrated service，Makes Bet365 app download the elderly from leaving the environment that they are familiar with，Dignificantly accepts professional and appropriate care in the community or home。2，Integrated resources，Effective integration of support services and facilities provided by the formal care forces，To integrate resources、Expressive、Can be available，The goal of reaching the energy increase efficiency of community pension services。third，Pay attention to the formal and informal care forces，Deliven to establish a social support service network with a integrated tendency，Provide a comprehensive to the service object、continuous service。Fourth，Integrated service goal is to provide caregivers with appropriate support and services for caregivers，Gradually build a good -neighborlyization、Humanized caring community，Stimulate the volunteer resources within the community，Improve the overall retirement ability of society。

　Medical and Nursing Combination Service achieves certain results

The practice of integrating elderly care services in China has been in China for several years，Mainly exist in the form of a combination of medical care，Get a certain effect。Look from the local practice，At present, there are three types of local development medical care combination services。

The first category is institutional medical care combination service。Medical and Nursing Combination Service involves two types of services: medical and pension，Two types of services are essentially inseparable。In the past, the two departments each were politics，Health service is managed by the health planning department，Pension service is managed by the civil affairs department。Both departments have set up some thresholds in medical integration services。For example，The establishment of a medical institution for the elderly institution must set up an elderly sick hospital bet365 live casino games for the elderly in the health and family planning department、Rehabilitation Hospital、Nursing Institute、Chinese Medicine Hospital、Hiroshi Care and other medical institutions are included in the regional health planning; and public medical institutions to set up pension beds should also be set up in accordance with the regulations of the civil affairs department。To accelerate the improvement of relevant regulations as a constraint with each other，Effectively promote the healthy development of the medical and nursing -nursing institution。

2015，Some places start trying to make some changes in the combination of medical care。Take Shandong Province as an example，Shandong Province's implementation of parallel approval of the new medical and nursing institution，Medical institutions with legal person qualifications apply for establishing pension institutions，No need to set up new legal persons separately; medical institutions to build medical institutions can operate in accordance with the principle of "non -prohibited"，Reduced the threshold for medical institutions to run a medical institution。Under this policy dividend，Many medical institutions and pension institutions have seen huge development prospects，One after another invested in capital reconstruction or a new medical and nursing combination institution。In the past two years，"Medical and Nursing Combination" agency has grown very quickly，A new medical and nutrition institution in the eastern city has doubled a year before it.。

The second category is community medical care signing service。As mentioned earlier, Western developed countries are also promoting "integrating pension services"，More "home medical care signing service"，Because the institutional medical care costs are high，Medical insurance (or nursing insurance) burden heavy bet365 best casino games burden。In recent years，More and more Western countries advocate the trend of "de -institutionalization"。"Destinization"，Just keep the elderly in the community as much as possible，Through community medical institutions、Career、Social service agencies and even some smart companies participate，Monitor the health level of the elderly in all directions，Provide appropriate home medical care for the elderly、Pension Service，Make the elderly without leaving home，Enjoy the same service quality as the organization，At the same time, do not leave the family and loved ones。This is of course an ideal pension mode。my country is also practicing the "medical treatment contract" at the grassroots level，But it also emphasizes "Signing Agreement with a small pension institution without a medical institution through the grass -roots community health service center，Carrying out a visiting service "。Speaking of which，This is also a signing between institutions and institutions，It's just that the service agency moves down，Reduced the original institutions above the second level into a first -level institution，However。This mode is centered with the old man in the West，Lead "home service"，There is a certain distance to provide the elderly with an integrated home service。

The third category is the combination of home medical care。On the home care contracting service，Preliminary explorations in some places。From the development of the long -term care insurance system of Qingdao，Provide sustainable bet365 live casino games for the elderly in the future、High -quality "family care" is a dominant direction for the combination of medical care。

　Combination of medical care from the supply party to the demand party

Now，As the population aging intensifies，Medical Nursing Combination Service has important value。First，Medical and Nursing Combination Service System is based on the needs of the elderly，Bet365 app download Based on professional services，Breaking the institutional barriers between the traditional medical system and the pension system，Provide hospitalization for the elderly、Rehabilitation Period Nursing、The health and pension service of life -care and end care of life care，greatly improved the quality of life of the elderly in his old age。Next，Medical and Nursing Integration Service is an important supplement to the core of traditional home -care services。With urbanization、Marketization、Development of trends such as declining childization，More and more urban and rural elderly people become empty nest elderly，It is difficult to maintain the long -term care function of the original dependent family。In this case，Society urgently needs to establish a supplementary service system to make up for the lack of family functions。The existing medical and nursing combination system integrates the institution -community -home third -level pension service system，But from the perspective of resource allocation structure，Generally tilted to the organization，Insufficient emphasis on family functions，Insufficient investment in home care service resources。

The future development of the medical and nursing combination system，Need to transfer from the demand party from the supply direction。From the perspective of the integration service model of the integrated pension in developed countries or the service model of my country's medical care and nursing combination，Home medical care services are all the key。Develop home medical care services，The point is not to establish more institutions，Improve operational subsidies and construction subsidies to various institutions，and gradually improve the ability to pay for the elderly，Develop and improve long -term care insurance，Gradually improve bet365 live casino games the payment level of long -term care insurance。Based on this，The government should encourage social capital to participate in the medical and nursing combination service，Pay and regulate through long -term care insurance，Establish a fair market competition order，Gradually improve the efficiency and quality of the combination of medical care。

(Author Unit: Institute of Sociology, Chinese Academy of Social Sciences)