Research On The Collaborative Mechanism Of Community Embedded Medical And Care Service Model

With the national policy of "connecting primary health care institutions and community aged care services" proposed in 2015,and "Community-based medical and nursing capacity improvement projects" proposed in 2019,the role of communities in medical-care integration becomes more important.The community-embedded medical-care integration model is a new type of old-age care model,which combines the advantages of geography,flexibility,and richness of the existing levels of old-age care services,and provides important solutions for alleviating the contradiction between supply and demand of medical-care integration services in China.Due to multiple subjects in the community-embedded medical-care integration model,the characteristics,motivations and behavior choices of each subject affect the effect of service provision.The research on the collaborative mechanism and ways to optimize the integration of various subjects in the development of the community-embedded medical-care integration service is of great significance.Based on the theory of welfare pluralism and collaborative governance,this paper proposes an analysis framework that includes four dimensions and eleven secondary dimensions.Four dimensions include the external environment,collaborative drivers,collaborative processes,and collaborative results.Based on the field investigations of JiangNan Street,YanJing caring home and RiHui nursing home,we can sorts out the synergistic mechanism and internal logic of multiple subjects of three different specific models.By comparing three types of community-embedded medical-care integration model,we find they are different in key power,organizational and resource mechanisms,network formation patterns,and management mechanisms.The study found that multi-sector collaboration reduced the effectiveness of policy implementation and cause insufficient coordination motivation.Besides the coordination process lack of standardized institutional guarantees and flexible trust foundation.In addition the coordination results lack of two-way supervision and targeting.In response to the corresponding problems,this paper makes the following suggestions,improving the government’s cross-department coordination capacity and policy implementation,promoting coordination through effective incentive mechanisms and administrative measures,reducing institutional blockage and increasing the foundation of trust,improving supervision methods and target positioning.