Yuan Shasha, Jia Meng, Wang Fang
Institute of Medical Information & Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China.
Int J Integr Care. 2022 Jun 10;22(2):20. doi: 10.5334/ijic.6419. eCollection 2022 Apr-Jun.
Implementing integrated care for the aged population has been regarded as a mechanism to achieve healthy ageing. However, evidence from undeveloped nations has been scant. This study aims to explore the integrated care experience in Anhui and Fujian Province of China based on the Rainbow Model of Integrated Care (RMIC).
The qualitative study was conducted in Anhui (in the middle area) and Fujian Province (in the eastern area) between May and September in 2018. The interviewees included twenty-eight policy makers working at departments of health and civil affairs at different levels and seventeen heads of medical and elderly care institutions.
The preliminary progress of integrated care in the sample cities of two provinces are mainly shown at solid policy basis by multiple key government agencies and political commitment achieved (system integration); preliminary coordination mechanism established between medical and elderly care institutions (organizational integration); consolidation of multi-disciplinary collaboration (professional integration); and reinforced role of family doctor teams for community-home dwelling elderly (service integration). Main challenges are also identified at insufficient inter-agency coordination, weak service capacity, lack of sustainable funding schemes, low level of information integration, and shortage of professional supply.
Our findings provide a feasible path for other countries to strengthen integrated care for the aged population, particularly for those confronting rapid population ageing but with fragmented health care and elderly care systems.
实施针对老年人群的整合照护被视为实现健康老龄化的一种机制。然而,来自不发达国家的相关证据却很少。本研究旨在基于整合照护彩虹模式(RMIC)探索中国安徽省和福建省的整合照护经验。
2018年5月至9月间,在安徽省(中部地区)和福建省(东部地区)开展了定性研究。受访者包括28名在不同级别卫生和民政部门工作的政策制定者以及17名医疗和养老机构负责人。
两省样本城市整合照护的初步进展主要体现在多个关键政府机构奠定了坚实的政策基础并达成了政治承诺(系统整合);医疗和养老机构之间建立了初步协调机制(组织整合);巩固了多学科协作(专业整合);以及加强了家庭医生团队对社区居家老年人的作用(服务整合)。同时也发现了主要挑战,包括机构间协调不足、服务能力薄弱、缺乏可持续资金方案、信息整合水平低以及专业供给短缺。
我们的研究结果为其他国家加强老年人群整合照护提供了一条可行路径,特别是对于那些面临人口快速老龄化但医疗保健和养老体系碎片化的国家。