During the Spring Festival, some elderly patients who do not want to go to the hospital and have limited mobility can enjoy medical services at home and share the joy of the festival with their families. This stems from the fact that in order to actively cope with the aging of the population, the state has continuously promoted the implementation of home medical services such as medical care and family beds in recent years. Recently, the reporter came to the Shanghai Street Community Health Service Center in Taijiang District, Fuzhou City, Fujian Province, to visit the development of its home medical services.
Leave the inconvenience to yourself
Leave peace of mind to the patient
At 8:00 a.m., with a drizzle, Lin Yan, a community nurse, took an umbrella and a medical kit and set off in a special car.
After receiving an appointment for intravenous blood draw and intravenous injection service from two patients on the "Shengyitong" mini program the day before, she immediately called him to communicate with her about the service time and specific needs of medical care, and then prepared for the door.
One of the service objects is Grandma Li, who is more than 70 years old, she has a history of diabetes, mobility is inconvenient, not long ago because of insufficient qi and blood, the doctor prescribed a pulse injection, which requires medical staff to come to the door to inject. Grandma Li's family lives in the old town of Gulou, and the crowded streets make community medical workers encounter parking problems every time they come.
After getting out of the car, Lin Yan pointed to the old building in front of him and told reporters: "This is an old community, there is no elevator, the old man is on the 7th floor, we have to climb up." After climbing 3 floors, Lin Yan signaled to take a break: "Because of pregnancy, I can't keep up with my physical strength recently." After a short rest, she climbed 4 floors in a row and finally came to the door of Grandma Li's house.
Knocking on the door, Lin Yan put on the shoe covers prepared in advance, walked into Grandma Li's bedroom, and gently asked: "Grandma, how do you feel today?" ”
"I felt like I was going to die last night!" Grandma Li was lying on the bed, and when she saw Lin Yan immediately open the conversation box, her brow furrowed as she described her experience of angina last night. Lin Yan patiently listened, suggested that Grandma Li seek medical treatment immediately if angina occurs again, and instructed the family to support the elderly when they go to the toilet to prevent falling. Grandma Li's nervous expression looked much relieved.
After the injection, after observing for a period of time, Lin Yan found an abnormality when she looked at the blood glucose record table next to the bed. "After injecting insulin, the blood sugar value is still so high at 4 p.m."?" Lin Yan suggested that you change a blood glucose meter and check it again.
Grandma Li's son told reporters that before going to the community health service center for treatment, the old man was breathless every time he went downstairs, and the old man was even more reluctant to run to the hospital during the New Year, and after inquiring, he knew that he could ask a doctor to come to the door, which suddenly solved the family's troubles.
After completing the two door-to-door services, it was already 10 a.m., and Lin Yan returned to the community health service center to continue her work.
There is medical care in the short term
Long-term home hospital beds
"Since 2019, the center has provided 14 medical care home services such as intravenous injection, catheterization services, and pressure ulcer care for patients with short-term care needs. Up to now, it has served more than 3,000 people. For the elderly aged 60 and above who are in clear and stable condition and have long-term medical needs, the center has set up a family bed service, in addition to providing door-to-door services such as dressing change, stitch removal, and urinary catheterization, it can also provide more than 60 services such as biochemical examination, wound care, nasogastric care, and enemas. Cheng Lanzhen, the relevant person in charge of the Shanghai Street Community Health Service Center in Taijiang District, introduced to reporters.
Cheng Lanzhen said: "Of course, not all patients can build beds. After the patient submits the application, we will send a special person to visit the patient's condition and the actual situation of the environment to determine whether it meets the requirements for building a bed. Patients who apply can build beds at home twice a year, not more than 90 days at a time. ”
Nurse Jiang Huiling, head of the family bed, further introduced that Fuzhou City launched the pilot of family bed service on February 1, 2021, and the Shanghai Street Community Health Service Center in Taijiang District, as one of the first pilots, began to implement the family bed service from May last year, and has received more than 40 bed applications so far, with a total of 10 beds. The center's 4 doctors and 6 nurses work shifts to provide home hospital bed services for patients, and 1 doctor with 1 nurse comes to the door once a week, which will increase the frequency of household visits when there are special circumstances.
Why is home care so popular? Jiang Huiling calculated an economic account with the reporter: patients charge 100 yuan per bed construction cycle, during the construction of the bed, the doctor comes to the door every week to carry out routine inspections, each time charging 50 yuan; eligible insured patients, the medical expenses generated during the bed construction period can be settled according to the standard standards stipulated by the medical insurance department; if calculated according to the hospital general ward bed fee of 40 yuan per day, in the 90-day bed building cycle, only the bed fee can save thousands of yuan.
"Judging from the current bed construction situation in our center, patients only need to pay about 20 yuan per day to enjoy long-term home medical services." Coupled with the general reluctance of the elderly to leave home for hospitalization, and the inconvenience of family escort, this service can indeed bring many tangible benefits to patients and families. Jiang Huiling said.
Patients enjoy the convenience and affordability of home service, but the effort of doctors and nurses is doubled. "On the one hand, it is necessary to take into account the normal operation of the work of community health service centers; on the other hand, door-to-door services often bear more risks and pressures." Jiang Huiling said, "It takes time on the road, it takes forty or fifty minutes to go to the clinic every time, and when you come back, you have to write a medical order, serve two patients, and the morning will pass." At the same time, doctors can see more than 10 patients. ”
A person's hospital bed
A doctor for a family
Home medical services such as medical care home are convenient for patients and also make the doctor-patient relationship more harmonious.
"In fact, home medical services are not only to see patients, but sometimes incidentally to see the patients' families' illnesses." Jiang Huiling said with a smile that in the process of serving patients who establish family beds, they will also give some suggestions when they encounter patients whose families are unwell.
The establishment of family beds has also increased the trust between doctors and patients, and more patients' families have begun to be willing to see a doctor and take medicine in the community health service center. "Not long ago, the patient's family came to us to get the new crown vaccine, and before coming, they also learned from us that there were not many people queuing up." Jiang Huiling said.
With the continuous release of the masses' demand for home medical care, Fuzhou Has also accelerated the pace of deployment. It is reported that as of the end of November last year, 22 medical institutions in Fuzhou have carried out pilot projects and have accepted more than 240 applications for family bed service. This year, Fuzhou will strive to achieve a coverage rate of more than 50% of the primary medical and health institutions for family bed services.
Text: Health Daily reporter Wu Qian Chen Jing
Editor: Guan Zhongyao
Review: Chen Huiyang Yan Gong