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中国的健康与照护整合:经验教训与未来展望

Integrating Health and Care in China: Lessons Learned and Future Outlook.

作者信息

Hu Linlin, Glavin Ye-Fan Wang, Yan Runnan, Pei Chenyang, Yan Mudan, Zhang Yu'ou, Liu Yuanli

机构信息

School of Health Policy and Management, Peking Union Medical College, Beijing 100730, China.

School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA.

出版信息

Int J Integr Care. 2021 Nov 8;21(4):18. doi: 10.5334/ijic.5681. eCollection 2021 Oct-Dec.

Abstract

BACKGROUND

An aging population is one of the key drivers reshaping health care systems. In China, the complex needs of its huge aging population require integration across the health and care sectors.

POLICIES AND PROGRESS

Over the past decade, the central government of China promulgated a series of policies to promote the establishment of aftercare facilities, specify approaches to integrate health and care service delivery at institutional and community levels, pilot long-term care insurance (LTCI) as a funding mechanism, and reform administrative structures in favor of integration. Progress has been made towards organizational and clinical integration of service delivery both at institutional and community levels. LTCI has been introduced as the financing mechanism covering long term care services.

DISCUSSIONS AND CONCLUSIONS

The experiences of China in the integration of health and care could be summarized as a top-down approach in policy formulation and implementation, the significant employment of pilots and demonstrations, and the activation of market forces. However, China is still in the initial stage of integrating health and care and is faced with system-level challenges in its financing, management, and workforce, and faces technical challenges, such as a lack of tools, and standards. In the future, these issues need to be addressed.

摘要

背景

人口老龄化是重塑医疗保健系统的关键驱动因素之一。在中国,庞大老年人口的复杂需求要求卫生与照护部门进行整合。

政策与进展

在过去十年中,中国中央政府颁布了一系列政策,以促进建立善后设施,明确在机构和社区层面整合卫生与照护服务提供的方法,试点长期护理保险(LTCI)作为一种筹资机制,并改革行政结构以利于整合。在机构和社区层面的服务提供的组织和临床整合方面已取得进展。长期护理保险已作为涵盖长期护理服务的筹资机制推出。

讨论与结论

中国在卫生与照护整合方面的经验可概括为政策制定和实施中的自上而下方法、大量采用试点和示范以及激活市场力量。然而,中国仍处于卫生与照护整合的初始阶段,在融资、管理和劳动力方面面临系统层面的挑战,并面临技术挑战,如缺乏工具和标准。未来,这些问题需要得到解决。

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