| BackgroundAccording to ’The Aging Population Trends in China’issued by the Association for the Elderly,the old people will be increasing more rapidly from 2021 to 2050 in China,and reach a ’severe aging phase’.Actually aging has become a serious problem which needs to urgently addressed.The government made various policies to meet the needs of the aging population,but there are still many problems.In 2011,the State Council issued"The China ’twelfth five-year’ Plan for the Elderly and "The Social Service System Plan for the Elderly(2011-2015)" which put forward a comprehensive health care system providing diverse care needs for the elderly.In February,2017,the State Council issued "The Thirteenth Five-year Plan Construction Plan for the Elderly" which set new goals and requirements for the forseeable future care service of the elderly.In October 2017,President Xi’ emphasized the importance of addressing the aging problem s in the keynote report delivered at 19th CPC National Congress.The combined health care model is a service model which not only provides daily care and spiritual comfort for the elderly,but also emphasizes diagnosis and treatment of illnesses,medical check and the rehabilitation of serious illnesses and end of life care.It involves institution-based,community-based and home-based care services.But due to the lack of nurses and financial support etc,it is impractical to implement it.ObjectivesThe special care hospitals were built to provide medical care and support for the disabled soldiers or those veterans who suffered severe chronic diseases or mental illnesses in military service.These hospitals receive much financial support from the government,and are well equipped with medical facilities.But at present these hospitals are not fully utilized by the patients.It is necessary to try a new combined health care model for the elderly in these hospitals,which is significant for the hospital’s development and the elderly’s health care.This paper aims to explore the status quo of the combined health care model in these special care hospitals,then analyze its advantages and feasibility,prospects and constraints and some suggestions are put forward.Research MethodologyResearch methods include questionnaire,semi-structured interviews.A total of 5 special care hospitals were involved in the survey.Some experts,hospital managers,medical workers from the hospitals were interviewed.Some professors from medical universities were also interviewed.SPSS 17.0 Statistical software were used to analyze the data to give a description.Colaizzi7 were used to analyze the interviews and generalize the themes.Results19 special care hospitals were surveyed,in which 68.4%are specialized hospitals,8 are above second-class level hospitals,5 hospitals practice the combined health care model.The 5 hospitals designated special care centers for the elderly.According to the elderly’s self-care ability,the elderly is classified into three levels:no self-care ability old people(confined to bed),half-self-care ability old people and self care old people.When they are free from illness,they just enjoy daily care and spiritual support from medical workers and do some recreational activities in the hospital.When they are ill,they are hospitalized and receive diagnosis and treatment.During the stabilization and recovery,they return to the previous care model.The average age of the surveyed elderly is 81.4 ± 8.3 years,and 85.4%of them suffer chronic diseases.Half of them have self-care ability.The leading causes for them to be admitted are their older age and chronic diseases and their children who have no time to take care of them.When the old people select these hospitals,what they prioritize are good service,medical facilities and easy access to treatment.The scores for physical function,psychological function,social function and material life in terms of life quality assessment are 63.44±10.12,66.45±6.21,68.75±9.8 6 and 62.44±6.5 respectively.The overall assessment score is 65.68±8,79,which is higher than that of the traditional nursing home.The overall satisfaction level is 91.7%.The hospital environment,medical service and living conditions are rated as most satisfactory.Semi-structured interviews indicate the hospitals which provide this combined model to the elderly are highly recognized just due to its speciality,fame and much financing.This model is feasible and it can help to promote the hospital’s development in the long run.But it may be faced with some difficulties such as lack of publicity and relevant health policy,the outflow of talented medical workers,low profits,and the high risks.Conclusion5 special care hospitals in Shandong Province are practicsing this combined health care model,which provide better service to the elderly to enjoy better life quality.Moreover,it is helpful to the hospital’s development in the long term.So the combined health care model can be put into practice in other special care hospitals.Given the constraints,the government and relevant departments should provide much funding to special care hospitals,which will help to improve infrastructure and care service level. |
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