Sauvaget C, Ogawa K, Tsuji I, Hisamichi S
Tohoku University Graduate School of Medicine, Department of Social Medicine.
Nihon Koshu Eisei Zasshi. 1998 Jul;45(7):664-74.
Dichotomy is the main characteristic of the Health and Welfare system in France. This system lies on two distinct fields, the medical field which is managed by the National Government, and the social field managed by the Local Government. The French home care policy for the elderly has developed a large number of services to assist in activities of daily living, to provide nursing and medical care at home, to improve living conditions, to maintain social relationships, and to postpone institutionalization and hospitalization, respectively. The main home care service is represented by "home helpers" who provide maid Notiniralics services. The second widely used service is the "home care service" performed by a team of nurses, assistant-nurses, psychologists, physiotherapists. This team provides nursing care and assistance in activities of daily living. As for institutions for the elderly, they are divided into welfare and medical institutions. The welfare institutions include social establishments like shelter homes and nursing homes. The medical institutions are mostly represented by long-term care hospitals. One of the main goals of the aging policy is to create medical wards in welfare institutions in response to the increased dependency of the institutionalized elderly. Recent experimental and innovative concepts have been established, such as "shelter homes for dependent elderly" for physically or cognitively impaired elderly.
二元化是法国健康与福利体系的主要特征。该体系基于两个不同领域，一个是由国家政府管理的医疗领域，另一个是由地方政府管理的社会领域。法国针对老年人的居家护理政策已经发展出大量服务，分别用于协助日常生活活动、提供居家护理和医疗护理、改善生活条件、维持社会关系以及推迟机构收容和住院治疗。主要的居家护理服务以提供女仆式服务的“家庭帮佣”为代表。第二种广泛使用的服务是由一组护士、助理护士、心理学家、物理治疗师提供的“居家护理服务”。这个团队提供护理服务并协助日常生活活动。至于老年机构，它们分为福利机构和医疗机构。福利机构包括诸如收容所和养老院之类的社会机构。医疗机构大多以长期护理医院为代表。老龄化政策的主要目标之一是，针对机构收容老年人日益增加的护理需求，在福利机构中设立医疗病房。最近已经确立了一些实验性和创新性理念，比如为身体或认知受损的老年人设立“失能老人收容所”。
