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随着我国老龄化程度加深，如何发挥医养结合供给能力、扩大服务范围成为急需解决的问题。本文概括了国内医养结合定义和医养结合模式，对比了国外长期照护模式，总结了国内外医养结合模式的差异，同时还对国内外医养结合效果评估进行了探索。最终总结出我国医养结合发展的两大研究方向，一是医养结合模式、路径的改革，二是医养结合评估体系的建立。医养结合模式、路径的改革促进基层医疗体系的改革和分级医疗服务的规划，医养结合评估体系利用衰弱及其不良后果对老年人健康状况进行分层和检测，完成对医养体系的效果评估。
Abstract：With the deepening of Chinese aging, how to give full play to the supply capacity of the combination of medical care and elderly care, and expand the scope of services has become an urgent problem to be solved. This paper summarized the definition of the combination of medical and nursing care in China and the model of integrated elderly care and medical cares, compared the long-term care models in foreign countries, and summarized the differences in the supply models of the combination of medical and nursing care at home and abroad. At the same time, it also explored the effect evaluation of the combination of medical and nursing care at home and abroad. Finally, two major research directions for the development of the combination of medical and elderly care in China were summarized. The first was the reform of the mode and path of integrated elderly care and medical care, and the second was the establishment of the evaluation system for the combination of medical and elderly care. The reform of the integrated elderly care and medical services promoted the reform of the grassroots medical system and the planning of hierarchical medical services. The evaluation system of the integrated elderly care and medical services used the frailty and its adverse consequences to stratify and detect the health status of the elderly, and completed the effect of the medical care system evaluation.
[1]徐春英.中国人口老龄化问题与养老对策研究[J].现代经济信息，2019,34(12):5-6.
[2]高鹏，杨翠迎，周彩.医养结合与老年人健康养老[J].财经研究，2022,48(4):124-138.
[3]李长远.医养结合养老服务的实践探索与推进策略——基于3个典型试点地区的观察[J].西南金融，2022,43(2):67-78.
[4]田原，徐广浩，杨广杰.青岛市医养结合养老模式的特点及经验启示[J].中国医药导报，2019,16(9):181-184.
[5]郭林.香港养老服务的发展经验及其启示[J].探索，2013,29(1):150-154.
[6]刘倩汝，王梦娜，耿力.我国医养结合养老背景下老年康复护理模式研究进展[J].护理学杂志，2022,37(5):20-23.
[7]穆光宗.“医养”该如何“结合”[J].中国卫生，2018,34(7):20-21.
[8]李志宏.医养结合：问题缘起、实践偏差与破解之路[J].老龄科学研究，2018,6(12):3-12.
[9]李婧，徐凤芹，柏燕军，等.中医医养结合养老模式探索[J].世界最新医学信息文摘，2019,19(60):26-27.
[10] FEDER J, KOMISAR H L, NIEFELD M. Long-term care in the United States:An overview:A complex system of public and private funding often leaves elderly persons at risk of financial catastrophe and inadequate care[J]. Health Affairs, 2000,19(3):40-56.
[11] LEUTZ W N. Five Laws for Integrating Medical and Social Services:Lessons from the United States and the United Kingdom[J].The Milbank Quarterly, 1999,77(1):77-110.
[12] CHATTERJI P, BURSTEIN N R, KIDDER D, et al. The impact of PACE on participant outcomes[EB/OL].[1998-07-01](2023-05-20). https：//www. cms. gov/Research-Statistics-Dataand-Systems/Statistics-Trends-and-Reports/Reports/Research-Reports-Items/CMS023314.
[13] BéLAND F, BERGMAN H, LEBEL P, et al. A system of integrated care for older persons with disabilities in Canada:Results from a randomized controlled trial[J]. J Gerontol A Biol Sci Med Sci, 2006,61(4):367-373.
[14] HEBERT R, RAICHE M, DUBOIS M F, et al. Impact of PRISMA, a Coordination-type integrated service delivery system for frail older people in Quebec(Canada):A quasi-experimental study[J]. J Gerontol B Psychol Sci Soc Sci, 2010,65B(1):107-118.
[15] LIU G, YAP P, WONG G H Z, et al. Day care centers for seniors in Singapore:Looking back and looking ahead[J]. J Am Med Dir Assoc, 2015,16(7):630. e7-e11.
[16] TAN K B, EARN LEE C. Integration of primary care with hospital services for sustainable universal health coverage in Singapore[J]. Health Syst Reform, 2019,5(1):18-23.
[17] LIM W, WONG S, LEONG I, et al. Forging a frailty-ready healthcare system to meet population ageing[J]. Int J Environ Res Public Health, 2017,14(12):1448.
[18]任雅婷，刘乐平，师津.本医疗照护合作：运行机制、模式特点及启示[J].天津行政学院学报，2021,23(4):87-95.
[19] KODNER D L. Whole-system approaches to health and social care partnerships for the frail elderly:An exploration of North American models and lessons[J]. Health Soc Care Community,2006,14(5):384-390.
[20]吴颖，邢慧洁，刘建云，等.我国医养结合标准化现状及建议[J].中国标准化，2022,65(4):79-84.
[21]林陶玉，唐昌敏.区域医联体背景下医养结合服务评价指标体系构建[J].医学与社会，2022,35(11):38-43.
[22]胡善菊，武春燕，杨锦茹，等.创建“医养结合示范省”的经验、问题与对策[J].卫生经济研究，2022,39(3):5-8.
[23]冯玉莹.“医养结合嵌入式”养老模式的必要性、困境与对策研究[J].云南民族大学学报（哲学社会科学版），2022,39(2):66-75.
[24] ROCKWOOD K, MITNITSKI A. Frailty in relation to the accumulation of deficits[J]. J Gerontol A Biol Sci Med Sci, 2007,62(7):722-727.
[25] MORLEY J E, VELLAS B, ABELLAN VAN KAN G, et al.Frailty consensus:A call to action[J]. J Am Med Dir Assoc,2013,14(6):392-397.
[26] YAMADA M, ARAI H. Social frailty predicts incident disability and mortality among community-dwelling Japanese older adults[J]. J Am Med Dir Assoc, 2018,19(12):1099-1103.
[27] OKURA M, OGITA M, YAMAMOTO M, et al. Community activities predict disability and mortality in community-dwelling older adults:Community activities predict mortality[J]. Geriatr Gerontol Int, 2018,18(7):1114-1124.
[28] MAKIZAKO H, SHIMADA H, TSUTSUMIMOTO K, et al.Physical frailty and future costs of long-term care in older adults:results from the NCGG-SGS[J]. Gerontology, 2021,67(6):695-704.
[29] CHEN S, HONDA T, NARAZAKI K, et al. Physical frailty and risk of needing long-term care in community-dwelling older adults:A 6-year prospective study in Japan[J/OL]. J Nutr Health Aging, 2019,23(9):856-861.
[30] TANAKA T, TAKAHASHI K, HIRANO H, et al. Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly[J]. J Gerontol A Biol Sci Med Sci, 2018,73(12):1661-1667.
[31] WOO J, YU R, WONG M, et al. Frailty screening in the community using the FRAIL scale[J]. J Am Med Dir Assoc, 2015,16(5):412-419.
[32] ROE L, NORMAND C, WREN M A, et al. The impact of frailty on healthcare utilisation in Ireland:evidence from the Irish longitudinal study on ageing[J]. BMC Geriatrics, 2017,17(1):203.
基本信息:
DOI：
中图分类号:C913.6;R197.1
引用信息:
[1]蔡金娜,张瑞秋,朱国栋.国内外医养结合模式与效果评估研究进展[J].老年医学研究,2024,5(01):68-73.
基金信息:
广州市民政科技基金课题揭榜挂帅技术攻关项目（GCAAL2022001,失智老人智能防护和新型干预模式研究及示范应用）; 广州市科技计划项目——2023年度行业科技协同创新中心建设专题重点研发计划（2023B04J0379,基于个人照护计划的智慧医养服务平台研究及应用）