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MBA论文_整体治理视角下广西医养结合养老服务研究

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整体治理视角下广西医养结合养老服务研究
研究生:程哲年级:2015级专业:社会保障
导师:黄海波研究方向:社会保障理论与政策
摘要
国务院于2013年推出“医养结合”政策,目前“医养结合”在全国还处于探索阶段
通过查阅知网发现,当前国内的有关医养结合的文献研究中,学者们运用定性和定量的方
法对东部沿海汉族聚集地区的发达省市,例如,上海、大连、青岛、合肥等城市医养结合
的模式、因素、存在的问题等进行研究,并提出了具有针对性的对策措施,从医养结合在
上海、青岛等沿海发达地区实践的情况和效果来看,它甚至可以作为当前应对我国人口老
龄化问题的长期解决方案。但是相对广西民族地区的而言,东部沿海地区的实践并不具有
普适性。相对于东部医疗和养老资源富足的省市,广西地处我国西南部,是一个集多民族、
多山地、多贫困人口、边疆等特征为一体的以壮族为主的少数民族聚集区,医疗和养老资
源较为贫瘠。受经济发展水平、民族人口特征及文化习俗差异等因素影响,广西“医养结
合”养老服务自然具有不同于东部沿海发达省市和汉族聚居地区的自身特点和规律。区内
南宁市、贺州市、百色市分别获民政部批准成为国家级医养结合试点城市,这为广西医养
结合事业的发展起到巨大的推动作用。本研究选取广西医养结合具有代表性的南宁市、贺
州市、百色市、桂林市,由于医养结合政策在广西才刚开始试点3年左右,医养结合机构
总量并不多,机构内老年人数量有限,因此,本研究主要运用访谈法对四个城市民政、卫
生等部门的负责人和医养结合机构以及机构内的老年人进行了访谈,在对访谈资料进行梳
理和分析问卷满意度调查数据的基础上,摸清了这些城市医养结合机构的现状及存在的问
题,主要表现在:政府部门的多头管理,政策的标准互不统一;医养资源分布不合理,有
效衔接机制不健全;医养服务的主体单一,缺乏市场社会的参与。运用整体治理理论对提
出对策建议:加强民政卫生部门协调,统一部门之间政策标准;优化医疗养老资源布局,
加大医养资源整合力度;鼓励不同主体提供服务,畅通市场社会介入渠道。探寻具有广西
特色的医养结合养老服务路径,从而实现广西地区老年人“老有所养,老有所医”
本研究分为五个部分:第一部分是绪论,介绍了本研究的背景、目的和意义,综述了
国内外医养结合的进展情况,说明了本文的研究内容和主要方法;第二部分是医养结合相
关概念,及对整体治理理论的渊源、概念、内容进的阐述;第三部分阐述广西医养结合养
老服务的现状,包括人口状况、机构状况、政策状况等;第四部分通过对广西四市医养结
合养老机构进行调研,弄清广西医养结合养老服务面临的问题。第五部分则是针对存在的
问题,提出进一步完善广西医养结合养老服务的对策与建议
关键词:整体治理;医养结合;养老服务;对策建议
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Research on medical care and pension service in Guangxi from the perspective
of overall governance
Postgraduate: Cheng ZheTutor: Huang HaiboGrade:2015
Major Social Security Research Direction: Social Security Theory and Policies
Abstract
In 2013, the State Council launched the policy of combination of doctors and nurses. At
present, medical support combination is still in the exploratory stage in the whole country. In
the literature research on the integration of medical care in China, scholars have studied the
models, factors and problems of the combination of urban medical care in the eastern coastal
Han gathering areas, such as Shanghai, Dalian, Qingdao, Hefei and so on. According to the
situation and effect of the practice of medical care in the developed coastal areas, such as
Shanghai and Qingdao, it can be used as a long-term solution to the problem of aging population
in China. However, the practice of eastern coastal areas is not universally applicable to
Guangxi's ethnic areas. Guangxi is located in the southwestern part of our country, which is
located in the southwestern part of China. It is a minority gathering area with the characteristics
of multi-ethnic, mountainous, multi poor and border areas. The medical and old-age resources
are relatively poor. Influenced by the economic development level, ethnic population
characteristics and cultural customs differences, Guangxi is naturally different from the
developed provinces and provinces in the eastern coastal areas. Nanning, Hezhou and Baise in
the district were approved by the Ministry of civil affairs to become a national pilot city for
medical care, which has played an important role in promoting the development of Guangxi
medical support. This study selects Nanning, Hezhou, Baise and Guilin City, which is a
representative combination of medical and medical care in Guangxi. Since the combination
policy of medical care has just started in Guangxi for about 3 years, the total amount of medical
care institutions is limited and the number of elderly people in the institutions is limited.
Therefore, this study only uses interview method for the civil affairs and health of four cities. On
the basis of combing the interview data, the leaders of the departments of other departments and
the medical support organizations and the elderly people in the organization have found out the
current situation and existing problems of these cities, mainly in the management of the
government departments, the standards of policies are not unified, and the distribution of medical
resources is not distributed. A reasonable and effective linkage mechanism is not perfect; the
main body of medical service is single, and lacks the participation of market society. Using the
overall governance theory, we put forward the countermeasures and suggestions: to strengthen
the coordination of the civil and health departments, to unify the policy standards among
departments, to optimize the distribution of medical endowment resources, to increase the
integration of medical resources, to encourage different subjects to provide services and to
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smooth the channels of market social intervention. We need to explore the path of medical
service combined with the old age in Guangxi, so as to achieve the goal of old age and old age
for the elderly in Guangxi.
This study is divided into five parts: the first part is the introduction, which introduces the
background, purpose and significance of this study, summarizes the progress of the combination
of medical care at home and abroad, and explains the contents and main methods of this study.
The second part is the related concepts of the combination of medical care and the origin,
concept and content of the theory of holistic treatment. The third part expounds the status of
Guangxi medical care and pension service, including population status, institutional status,
policy status, and so on. The fourth part makes a clear understanding of the problems faced by
Guangxi medical care and pension services through the investigation of the pension institutions
in the four cities of Guangxi. The fifth part is aimed at the existing problems, and puts forward
the countermeasures and suggestions for further improving the medical service combined
pension service in Guangxi.
Keywords: Holistic governance; Combination of medical care and pension; Service for the aged;
Countermeasures and suggestions。