Study On The Home-based Community Care Mode Of "Medical-nursing Combined" Based On Embeddedness Theory

With the development of aging to the depth and breadth,the wave of white hair has not only brought about the expansion of demand for pension services,but also led to increasingly severe health problems and growing demand for medical services.At present,the “medical-nursing combined” of the home-based community care is inadequate and the lack of services are difficult to meet the needs of the elderly in the community.However the home-based community care mode of“medical-nursing combined” with specialized medica-nursing service only be successfully embedded in the community,can effectively solve the problem of the existence of no medical service,separation of medical and nureing for the aged in the community.The policy documents on the combination of medical and nursing services require that medical and health services extend to communities and families,and promote the combination of grass-roots medical institutions and home-based community care for the elderly.Therefore,It is a realistic need and policy advocacy to study the home-based community care mode of“medical-nursing combined” and the embedded process of the mode,It has important theoretical and practical significance.Based on the embeddedness theory,the paper studies the operation mechanism of the home-based community care mode of“medical-nursing combined” embed in community.First,it analyzes the embedded principle,embedded process and embeddedhierarchy of the home-based community care mode of“medical-nursing combined”,and constructs the embedded index system from the three dimensions of the embedded effect.Secondly,based on the investigation and study of 188 community elderly and 97home-based community care stations as well as the statistical data of Community Health Service Centers(stations),the factors affecting the development of home-based community care mode of“medical-nursing combined” and the existing problems were obtained.Finally,the home-based community care integrated mode of“medical-nursing combined” including three seed modes was put forward,and analyzes the process of embedding into the community.The study found that: first,the medical service and nursing service of the the home-based community care mode of“medical-nursing combined” in Xi'an are not fully combined,the degree of combination needs to be improved.Second,the development of the home-based community care mode of“medical-nursing combined” in Xi'an has a positive correlation with the quality of service personnel,the quality of service organization,the policy of security and the management system.Third,there is a three seed modes of home-based community integrated care mode of “medical-nursing combined”,through interaction and transformation to form the home-based community integrated care mode of“medical-nursing combined”.Fourth,the home-based community integrated care mode of“medical-nursing combined” should be fully embedded in the community can play a better role.The contributions of paper is embodied in:(1)based on the embeddedness theory,paper analyzes the embedded principle,embedded process and embedded level of the home-based community care mode of“medical-nursing combined”,on the basis of sorting and summarizing the three seed modes,puts forward the the home-based community care integrated mode of“medical-nursing combined”,innovates the application object of the theory,provides a new way of thinking for developing the home-based community care mode of “medical-nursing combined ”.(2)According to the policy standards,it clarifies the service content of Community Health Service Center(station)and home-based community care station provided respectively,and makes a research on the the home-based community care mode of“medical-nursing combined” in Xi'an,it puts forward the home-based community care integrated mode of“medical-nursing combined ”,analyzes the embedding process and defines the way of embedding.