Poster Observation丨Under the trend of population aging, how to "open a new game" for elderly care services?

Poster News reporter Sun Dianxiao reports from Beijing

As the saying goes, "three points of treatment, seven points of care", nursing work is an important part of medical and health work. Nowadays, with the acceleration of the aging trend of the population in mainland China, the demand for nursing services for the elderly is becoming more and more urgent.

"At present, nursing work is facing a new situation." On May 11, Xing Ruoqi, deputy director of the Department of Medical Affairs of the National Health Commission, pointed out at a press conference that with the social and economic development, the improvement of people's health literacy and the update of health concepts, they hope to receive high-quality, humanized and diversified nursing services. At the same time, with the acceleration of the aging society, most of the elderly have multi-disease coexistence, and the social demand for geriatric care and geriatric-related chronic disease care is becoming increasingly strong.

In the face of the new situation and new changes, how to meet the growing demand for nursing services for the elderly?

Explore new models of elderly care services in many places

"The grassroots need to continue to improve the capacity of elderly care services." Peng Bin, vice president of Peking Union Medical College Hospital, said frankly.

Regarding the work of elderly care services, Peng Bin said that in addition to completing a large number of daily medical care work in the hospital, the hospital also actively promotes the assistance of primary medical institutions. It mainly accepts medical staff from primary medical institutions to come to the hospital for further study, and also regularly visits primary hospitals and communities for on-site guidance, ward rounds and continuous online support.

"Now there is a medical alliance, and we have good communication and cooperation with the medical alliance units to improve the ability of nursing services. For example, the geriatric nursing team of Union Medical College regularly visits community hospitals and health centers to popularize science for the elderly, focusing on the prevention and intervention of common diseases of the elderly, such as cardiovascular and cerebrovascular diseases, common symptom management and prevention of falls in the elderly, and how to avoid malnutrition in the elderly, so as to improve the healthy lifestyle and health literacy of the elderly. Peng Bin said that the elderly nursing team also regularly goes to the community to train grassroots nurses, conduct lectures, nursing rounds, carry out workshops, etc., and provide hands-on guidance for problems that arise in nursing work, especially at the grassroots level, which effectively reduces the risk of community nursing, allows the elderly to receive nursing services in the community with peace of mind, reduces referrals to other medical institutions such as large hospitals, and also improves the service capacity of community nursing.

In fact, many places are also actively exploring new models of elderly care services. The poster news reporter learned that in recent years, Hunan Province has jointly issued relevant documents to accelerate the development of geriatric nursing services, formulated guidelines for the construction and capacity improvement of geriatric medicine, strengthened the comprehensive assessment of the elderly, the diagnosis and treatment of multiple diseases, the safety of elderly patients, rehabilitation and palliative care management, explored the excellent service of hospitals, and supported the development of geriatric medical care.

"There are 14.604 million elderly people in Hunan Province, accounting for 22.23% of the total population of the province." According to Zhu Yimin, deputy director of the Hunan Provincial Health Commission, Hunan Province has also increased the number of elderly medical care institutions through transformation and social forces. At present, there are 108 rehabilitation hospitals, nursing homes and nursing centers in the province, providing more than 40,000 beds for geriatric medical care services, training more than 27,000 geriatric nursing professional nurses and more than 10,000 geriatric medical nurses.

Zhu Yimin said that in the next step, Hunan Province will take multiple measures to continue to promote the high-quality development of elderly medical care. In terms of strengthening the construction of the elderly nursing team, a three-level geriatric nursing (nursing) chain of "nurses-caregivers-caregivers" should be built to maximize the efficiency of geriatric nursing human resources. In terms of optimizing multidisciplinary collaboration, we have established multidisciplinary nursing collaboration teams such as geriatrics, rehabilitation, nutrition, and traditional Chinese medicine to provide patients with personalized "one-stop" geriatric care services. In terms of data empowerment, big data is used to realize intelligent matching and real-time contact between caregivers, homebound elderly and family members; Integrate resources with "Internet + nursing services", extended nursing services, home nursing services, and medical alliances to provide integrated nursing services such as "online consultation, door-to-door service, and popular science education" for the elderly.

Pilot coverage of geriatric health care services will be expanded

After all parties actively explore and take the lead in the trial, what is the progress and effectiveness of the elderly care service?

On May 11, Xing Ruoqi said at a press conference that in order to accelerate the development of elderly care services, the National Health Commission identified 15 provinces and cities including Beijing in 2021 to take the lead in the trial, accumulate local experience, and achieved certain results.

In terms of expanding the resources of medical services for the elderly, Xing Ruoqi introduced that the number of nursing homes, nursing centers, nursing stations and other institutions in the pilot provinces has increased significantly through transformation or social forces, with an average increase of about 16%. Jiangsu Province, Shandong Province and other places have expanded the number of beds in primary medical institutions to provide elderly care, and Jiangsu Province has added nursing home signs to community service centers, which can provide better nursing services for the elderly who are disabled, demented and unable to take care of themselves in the community. At the same time, all localities have also increased the training of nurses and medical nurses specializing in geriatric nursing, and effectively expanded the supply of geriatric nursing services.

In terms of innovating and diversifying the geriatric medical care service model, the pilot provinces are also actively exploring the continuous extension of in-hospital nursing services to communities and families through door-to-door visits, day care centers, "call centers" or family beds, etc., so as to make nursing services more convenient and accessible.

In terms of exploring the price payment policy for geriatric medical care, some provinces and cities organically combine the home medical care services for the elderly with local long-term care insurance policies, or develop commercial nursing insurance linked to long-term care insurance, etc., to provide supporting policy guarantees for the development of geriatric care services and benefit more elderly people.

Xing Ruoqi said that in the next step, the National Health Commission will continue to increase the promotion of elderly care services, further expand the coverage of the pilot of elderly medical care services, promote the good experience and practices of local pilots, and accelerate the development of elderly medical care services across the country.

She pointed out that the relevant pilot provinces can further expand the number of pilot cities, and the National Health Commission will also increase the coverage of the pilot if there are eligible provinces outside the pilot provinces. At the same time, we will continue to increase the number of community multi-functional nursing institutions, day care centers and other institutions, and further expand the supply of diversified elderly care services. In addition, we will speed up the construction of the team of geriatric nursing practitioners, guide the implementation of geriatric nursing professional nurse capacity training actions, and strive to by 2025, the proportion of geriatric nursing professional nurses participating in the training will not be less than 90%.

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