| ObjectiveIn this study,an empirical research on the community-home care service to find out the demands of the elderly in the community of Guangzhou was conducted.And then on this basis,an innovative approach to construct community home care services,which is merged Chinese medicine characteristical services was put forward.At last,an empirical research was help to explore the effectiveness and feasibility of the relevant methods,in order to promote the comprehensive reform of medical-nursing combined service in Guangzhou and even the whole nationwide.Method(1)Questionnaire survey.Using the self-designed "The demands of medical-nursing combined service of community home care elder in Guangzhou"to survey the community home care elders who were more than 60 years old living in one of the 5 community neighborhood committees in Dong jiao Street,Li wan District,Guangzhou.In this survey,a random sample questionnaire was used to get relevant information.After that,the descriptive statistics was also used to analysis the demands of medical-nursing combined service of community home care elder in Guangzhou.(2)Field interviews.Interviews were carried out for the Bureau of Civil Affairs of Guangzhou Municipality,City Working Committee on Aging of Guangzhou,City Pension Association of Guangzhou to grasp the status about the medical-nursing combined service in Guangzhou currently.Additionally,the problems of it was analyzed,in order to provide a basis for exploring innovative service models and management methods for the medical-nursing combined service.(3)Expert advice law.An empirical study on the feasibility and maneuverability about the model of "virtual Chinese medicine hospital" was made by consulting the related management and frontline staff of Community Service Center,Community Health Center of Dongjiao Street,Big Dipper social work service center,and Pension agency of Yihe.At the same time,the risks of it were found,measures which make it better were put forward.Result(1)By field interviews,we got that Guangzhou had already completed the construction of old age service net,which was composed of home care,community care and institution care.Furthermore,the elderly would receive services by various forms including day care center,old star home,home care service center,pension institution.Moreover,conditional pension institutions tried to provide "medical-nursing combined service" by provision of nursing homes and other forms.At the same time,in the medical system,most of the community health service centers set up health files for the elderly and provided health care and health counseling service for them through the National Basic Public Health Service project.And some conditional hospitals tried to provide"medical-nursing combined service" by setting up gerontology specialist and rehabilitation medical specialist.Generally speaking,although the"medical-nursing combined service" in Guangzhou got small achievements,there were some problems in it.Firstly,the integration of medical resources and old-age resources was inadequate and besides the service providers were relatively single.Secondly,community advantage had not been fully utilized.Thirdly,the demands of the elderly during treatment were on focus while the demands after treatment were not.What is more,highly attention was pay for the medical and nursing services,while spiritual comfort services were neglected.(2)The results of the survey show that nearly half of the elderly were willing to choose Chinese medicine medical institutions as service providers;and more than 60%of the elderly choose primary health care institutions to receive their first medical treatment.Additionally,expert doctors were the important factors which attract elderly to receive their first medical treatment in top hospitals.Finally,it was concluded that elderly had a relative high degree of acceptance of Chinese medicine services.And if more expert doctors work in primary health care institutions,more elderly would come back primary health care institutions to have first medical treatment.(3)On this basis,the model of "virtual Chinese medicine hospital" was proposed.Its feasibility and operability were discussed by empirical research.Simultaneously,its risks were found out and optimized measures were recommended.ConclusionThe results showed that the model of "virtual Chinese medicine hospital"was feasible and operable,which can be further popularized.But some measures should be carried out to make it better.For instance,establish expert team to solve the problem of lack of experts,develop the Community Health Center soundly,promote more high-quality medical resources into the grassroots level by reforming the personnel management and pay performance system,increasing financial support,and completing the title assessment and promotion mechanism. |
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