在台湾基层医疗照护机构推动友善高龄政策之困境与因应策略。
Difficulties and countermeasures in implementing age-friendly policies in primary health centers in Taiwan.
机构信息
Department of Community Health, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
出版信息
BMC Health Serv Res. 2022 Nov 14;22(1):1346. doi: 10.1186/s12913-022-08770-0.
BACKGROUND
Taiwan is predicted to become a super-aged society by 2025, and primary health centers (PHCs) are set to play a crucial role in the care of older adults. The Taiwanese government has developed an age-friendly verification framework for PHC. The aims of this study were to explore the difficulties faced by PHC staff in the implementation of age-friendly policies and their solution strategies.
METHODS
This study adopted a qualitative research method. The first stage involved conducting five focus groups with the responsible staff of PHCs (n = 41) that have been certified "age-friendly." The focus groups covered the effectiveness, difficulties, and resources of PHCs in regards to the introduction of age-friendly policies. In the second stage, in-depth interviews were conducted with executives of PHCs (n = 5), both certified and not certified as age-friendly, to further compare the difficulties faced by these two types of PHCs, thereby gaining perspectives for solution strategies. The principles of grounded theory were used for data analysis.
RESULTS
Four major PHC strategies are employed in the promotion of age-friendliness. First, organizational management, through which managers apply management methods and analyze the present PHC-related health concerns; second, resource utilization, which refers to the tallying, linking, and integrating of resources; third, business operation process, in which work efficiency is improved through the combination of business operations and staff training; finally, hardware improvement, which is achieved through comprehensive cataloging of facility environments.
CONCLUSION
The implementation of age-friendliness in PHCs requires the efforts of both the service units and government. With resources provided by the government, PHCs can integrate management methods, businesses operations, and essential resources. Moreover, PHC executives can lead their teams in promoting age-friendly policies, and closely monitor their effectiveness.
背景
台湾预计将在 2025 年成为超高龄社会，基层医疗保健中心（PHC）将在照顾老年人方面发挥关键作用。台湾政府已经为 PHC 制定了一个友好老龄化验证框架。本研究旨在探讨 PHC 工作人员在实施友好老龄化政策方面面临的困难以及他们的解决方案策略。
方法
本研究采用定性研究方法。第一阶段包括与已经通过“友好老龄化”认证的 PHC 负责人员进行五次焦点小组讨论（n=41），讨论涵盖了 PHC 引入友好老龄化政策的效果、困难和资源。第二阶段，对已通过和未通过友好老龄化认证的 PHC 高管进行深入访谈（n=5），以进一步比较这两种类型的 PHC 所面临的困难，从而获得解决方案策略的视角。采用扎根理论的原则进行数据分析。
结果
促进老龄化友好型发展的 PHC 采用了四大策略。首先，组织管理，管理人员运用管理方法并分析当前与 PHC 相关的健康问题；其次，资源利用，指的是资源的盘点、链接和整合；再次，业务运营流程，通过业务运营和员工培训相结合提高工作效率；最后，硬件改进，通过全面盘点设施环境来实现。
结论
在 PHC 中实施老龄化友好型需要服务单位和政府的共同努力。在政府提供的资源支持下，PHC 可以整合管理方法、业务运营和必要资源。此外，PHC 高管可以带领他们的团队推动友好老龄化政策，并密切关注其效果。
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