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    我国“医养结合”政策实施现状与思考

    摘要

    随着我国老龄化程度的提高,发展医养结合是完善我国养老服务供给的重要举措,也是经济发展新的增长点,体现了人口结构变迁、经济和社会转型的必然性。在我国,医养结合政策实施的主体是民办养老机构而非公办养老机构,是基层医疗机构而非公立医院。但在政策具体落地过程中,存在发文“强调次数越多,地方执行的可能性越大”,以及“执行难度越低,执行的可能性越大”等情况。究其原因,多部门参与、各尽其责的协作机制对政策执行的目标存在一定的限制作用,如部门条块管理下的行政孤岛可能导致医养难结合、医疗资源垄断导致要素难流动更加剧了这一问题的严峻性。因此,应大力发展长期护理保险;鼓励地方将负债建设的公立医院和养老机构进行改制;在医疗卫生体制改革背景下提倡“医护分离”,实现医养结合。

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    Abstract

    With development of aging in China,carrying forward the combination of medical treatment and nursing care is an important strategic deployment to improve old-age services in China,and it is also a new growth point of economic development,which reflects the inevitability of population structure changes and economic and social transformation. In China,main organizations of combination of medical treatment with nursing care are private institutions and non-public institutions for elderly nursing care,and they are grass-roots medical institutions rather than public hospitals. However,in the process of carrying out the policy,there are situations such as “the more emphasis is made,the more possibility of execution by local governments” and “the little the difficulty of execution,the more possibility of execution”. of Multi-departments participation and cooperative mechanism and doing itself responsibility only have limited policy execution in a certain degree are main reasons. For example,administrative separation under the management of each one department may lead to the difficult for combination of medical treatment and nursing care,and department cooperation caused by the monopoly of medical resources,and all above reasons aggravate seriousness of this problem. Therefore,long-term care insurance should be developed actively,local governments should be encouraged to restructure public hospitals and institutions for elderly nursing care that are in debt,and “separation of medical treatment and nursing care” should be advocated in the context of reform for medical and health system to realize combination of medical treatment and nursing care.

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    作者简介
    朱凤梅:朱凤梅,民政部政策研究中心,助理研究员,主要研究方向为社会保障与公共政策。
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