首页|居家社区医养结合服务能力及提升路径研究:基于39个案例的模糊集定性比较分析

居家社区医养结合服务能力及提升路径研究:基于39个案例的模糊集定性比较分析

Research on the capacity and improvement path of home-and community-based integrated health and social care:A fuzzy-set qualitative comparative analysis based on 39 cases

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目的:实证分析我国居家社区医养结合服务能力的多元驱动路径,为促进医养结合服务体系完善提供有益参考.方法:基于世界卫生组织老年人综合照护(ICOPE)实施框架构建分析框架,选取我国无锡市、焦作市、长沙市、成都市、重庆市的39 个区(县)作为样本案例,采用模糊集定性比较分析(fsQCA)方法剖析高或非高水平居家社区医养结合服务能力的组态路径.结果:居家社区医养结合服务能力的提升是各要素组合作用的结果.研究发现4 条路径组合将有助于居家社区医养结合服务能力发展,另有3 条路径组合或将阻碍居家社区医养结合服务能力发展;制度环境支持、筹资保障水平与区域老年人口需求程度是其中的关键因素.结论:我国居家社区医养结合服务能力受到多重因素间的相互作用与影响,应从多方面出发共同施策以提升服务能力.
Objective:Empirical analysis of the multiple driving paths of service capabilities of home-and community-based integrated health and social care in China,for providing useful reference for promoting the system improvement.Methods:Based on the World Health Organization's Integrated Care for Older People(ICOPE)implementation framework,an analysis framework for service capabilities of home-and community-based integrated health and social care was constructed.39 districts(counties)in Wuxi,Jiaozuo,Changsha,Chengdu,and Chongqing were included.The fuzzy-set qualitative comparative analysis(fsQCA)method was used to analyze the configuration paths of high or non-high-level service capabilities of home-and community-based integrated health and social care.Results:The service capabilities of home-and community-based integrated health and social care is improved by the configuration of various factors.Four path configurations might contribute to the development of service capabilities of home-and community-based integrated health and social care,and three path configurations might hinder the development.Institutional support,financing mechanism and the demand level of regional aging population are the key factors.Conclusions:Service capabilities of home-and community-based integrated health and social care are affected by the interaction and interrelation between multiple factors.Strategies should be jointly implemented from different aspects to improve service capabilities.

Population agingHome-and community-basedIntegrated health and social careService capabilityQualitative comparative analysis

刘思琦、赵君、刘楠、邓淏晏、陈琦、王芳

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中国医学科学院医学信息研究所/卫生体系与政策研究中心 北京 100020

北京协和医学院 北京 100005

中国医学科学院/北京协和医学院卫生健康管理政策学院 北京 100005

人口老龄化 居家社区 医养结合 服务能力 定性比较分析

中国医学科学院医学与健康科技创新工程经费资助项目国家卫生健康委委托项目中国医学科学院医学信息研究所所馆青年人才培养专项资助项目

2021-I2M-1-0462024YT13

2024

中国卫生政策研究
中国医学科学院

中国卫生政策研究

CSTPCDCHSSCD北大核心
影响因子:1.442
ISSN:1674-2982
年,卷(期):2024.17(9)
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