Department of Asian and Policy Studies, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong Special Administrative Region.
Department of Asian and Policy Studies, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong Special Administrative Region.
Health Policy. 2021 Mar;125(3):351-362. doi: 10.1016/j.healthpol.2020.12.020. Epub 2021 Jan 4.
Against the backdrop of rapid ageing populations, there is an increasing recognition of the need to integrate various health services for the elderly, not only to provide more coordinated care, but also to contain the rapid cost inflation driven primarily by the curative sector. Funded by the Asia-Pacific Observatory on Health Systems and Policies, this scoping review seeks to synthesize the received knowledge on care integration for the elderly in four Asian societies representing varying socioeconomic and health-system characteristics: Singapore, Hong Kong, Malaysia, and Indonesia. The search for English-language literature published between 2009 and 2019 yielded 67 publications in the final sample. The review finds that both research and practice regarding health service integration are at a preliminary stage of development. It notes a marked trend in seeking to integrate long-term elderly care with curative and preventive care, especially in community settings. Many distinctive models proliferated. Integration is demonstrated not only horizontally but also vertically, transcending public-private boundaries. The central role of primary care is highly prominent in almost all the integration models. However, these models are associated with a variety of drawbacks in relation to capacity, perception, and operation that necessitate further scholarly and policy scrutiny, indicating the robustness and persistence of siloed healthcare practices.
在人口快速老龄化的背景下，人们越来越认识到需要整合各种老年人健康服务，不仅要提供更协调的护理，还要控制主要由治疗部门驱动的快速成本通胀。本范围审查由亚太卫生系统和政策观察站资助，旨在综合四个在社会经济和卫生系统特征方面存在差异的亚洲社会中老年人护理整合方面的现有知识：新加坡、中国香港、马来西亚和印度尼西亚。对 2009 年至 2019 年期间发表的英文文献进行搜索，最终样本中包含 67 篇出版物。审查发现，卫生服务整合的研究和实践都处于初步发展阶段。它注意到一个明显的趋势，即寻求将长期老年人护理与治疗和预防护理相结合，特别是在社区环境中。许多独特的模式大量涌现。整合不仅在水平上，而且在垂直方向上，跨越公私界限。初级保健在几乎所有的整合模式中都发挥着核心作用。然而，这些模式与能力、认知和运营方面的各种缺陷有关，需要进一步的学术和政策审查，这表明分散的医疗实践具有强大的生命力和持久性。
