十三五规划明确提出：“要推进健康中国建设，积极开展应对人口老龄化行动， 推动医疗卫生和养老服务相结合”。党的十九大报告也明确指出：“要积极应对人口 老龄化，构建养老、孝老、敬老政策体系和社会环境，推进医养结合，加快老龄事业 和产业发展”。山东省委、省政府提出新旧动能转换和经济转型升级的 10 大产业，其 中重要的一项就是健康养老，对健康养老的政策支持力度不断加大，发展的环境不断 优化，为山东省以及蒙阴县的医养结合产业发展提供了重大机会。山东省临沂市委、 市政府充分认识积极应对人口老龄化挑战的重要性，强化顶层设计，把医养融合纳入 经济社会发展总体规划。临沂市蒙阴县委、县政府成立了大健康产业发展领导小组， 把大健康产业作为新旧动能转换的重点来抓，并积极申报省级医养结合示范县。这些 都为推进医养结合发展指明了方向，提供了遵循。 本文从研究新型医养结合养老模式的发展情况和研究意义入手，通过梳理和分析 国内外优秀研究成果，总结出适合我国北方沿海地区的基层医养结合发展的主要现状 和未来模式。明确医养结合的相关意义和模式，对医养结合养老模式的基本概念、基 本运作模式和生存现状等进行总结，并对医养结合下一步发展模式进行探究。运用企 业战略研究方法分析影响蒙阴县医养结合产业发展的因素，从宏观、微观两个方面分 析蒙阴县发展医养结合内部和外部的优势、限制条件和发展的潜力，为蒙阴县医养结 合产业发展制定切实可行的实施方案，解决当地面临的老年人养老、医疗服务问题和 政府投入过多造成的财政负担问题，为促进蒙阴县医养结合大健康产业的发展提供参 考。 最后得出蒙阴县医养结合产业发展战略的主要方式：一是适当发展医中有养产业 模式。医养结合机构运行标准要严格按照规范，重点支持医疗机构为老年人提供养老 服务。二是大力发展养中有医产业模式。支持养老机构开展医疗服务，建立医养合作 工作机制，鼓励社会资本注入医养结合行业。三是依托家庭医生服务和社区服务发展 居家巡诊产业模式。实现以家庭医生签约服务为总抓手的家庭养老与医疗预防相结合 的模式和以信息化建设为依托的一站式服务平台。四是大力拓展“医养+”产业模式。 将医养产业与传统产业相结合，大力推进发展“医养结合+旅游会展”、“医养结合+ 新型市场”和“医养结合+绿色无污染食品”等产业发展模式。 关键词：医养结合 SWOT 分析 波特五力模型 蒙阴县山东建筑大学硕士学位论文 V Study on the Development Strategy of the Integrated Medical and Nursing Industry in Mengyin County of Shandong Province ABSTRACT Suggestions on the 13th Five-Year Plan adopted by the Fifth Plenary Session of the Eighteenth Central Committee of the Communist Party of China clearly put forward: We should promote the construction of a healthy China, and actively. We should carry out actions to cope with the aging of the population and promote the integration of health care and pension services. The report of the Nineteenth National Congress of the CPC pointed out that we should actively deal with the aging of the population, construct the policy system and social environment of providing for the aged, filial piety and respecting the elderly, promote the combination of medical care and nursing, and accelerate the development of the aging cause and industry. Provincial Party Committee and provincial government regard healthy old-age pension as one of the 10 major industries of energy conversion between old and new and economic transformation and upgrading. Starting with the development and research significance of the old-age care model of the combination of medical care and maintenance, this paper summarizes the main course and mode of the development of the combination of medical care and maintenance in China by combing and analyzing the research results at home and abroad. This paper clarifies the related concepts of the combination of medical care and nursing, summarizes the basic concepts and operation modes of the combination of medical care and nursing for the aged, and explores the next development mode of the combination of medical care and nursing. This paper uses the method of enterprise strategy research to analyze the factors affecting the development of the industry of combining medical care with maintenance in Mengyin County, and from macro and micro aspects to analyze the advantages, limitations and development potential of developing the industry of combining medical care with maintenance in Mengyin County, so as to formulate a feasible implementation plan for the development of the industry of combining medical care with maintenance in Mengyin County and to solve the local problems. The problems of old-age pension, medical service山东建筑大学硕士学位论文 VI and financial burden caused by excessive government investment provide reference for promoting the development of health industry in Mengyin County. Finally, the main ways of the development strategy of the integrated medical and nursing industry in Mengyin County are concluded as follows: Firstly, vigorously develop the model of the integrated medical and nursing industry. It is necessary to strictly regulate the standards of medical and nursing institutions, and support medical institutions in carrying out pension services. Second, we should vigorously develop the model of health care industry. Supporting the development of medical services in pension institutions, establishing a mechanism for medical and nursing cooperation, and encouraging social capital to be injected into the industry of medical and nursing integration. Third, relying on family doctor services and community services to develop the home inspection industry model. Realize the combination of home care mode with family doctor contract service and community service based on one-stop service platform. Fourth, we should vigorously expand the health care plus industry model. We will develop such industrial development models as combination of medical care and maintenance + tourism, combination of medical care and maintenance + market and combination of medical care and maintenance + food. Key Words: medical and nursing combined，SWOT analysis，Potter five force model，Mengyin County山东建筑大学硕士学位论文 1 目 录 摘要........................................................................................................... III ABSTRACT................................................................................................... V 第一章 绪 论.................................................................................................3 1.1 研究背景.................................................................................................................3 1.2 文献综述..................................................................................................................3 1.2.1 国内研究现状..................................................................................................4 1.2.2 国外研究现状..................................................................................................5 1.2.3 研究评述..........................................................................................................6 1.3 研究思路和方法......................................................................................................6 1.3.1 研究思路..........................................................................................................6 1.3.2 研究方法..........................................................................................................7 1.4 选题的理论意义和创新点......................................................................................8 第二章 相关理论和分析方法.......................................................................9 2.1 相关概念..................................................................................................................9 2.1.1 发展战略概念...................................................................................................9 2.1.2 医养结合概念..................................................................................................9 2.2 相关理论................................................................................................................10 2.2.1 发展战略理论................................................................................................10 2.2.2 竞争战略理论................................................................................................10 2.3 分析方法................................................................................................................10 2.3.1SWOT 分析方法.............................................................................................10 2.3.2 波特五力分析方法........................................................................................11 第三章 山东省内外医养结合产业典型模式发展概况............................13 3.1 医养结合产业的发展历程....................................................................................13 3.2 典型模式................................................................................................................14 3.2.1 医中有养模式................................................................................................14 3.2.2 养中有医模式................................................................................................15 3.2.3 居家巡诊模式................................................................................................15山东建筑大学硕士学位论文 2 3.2.4 医养+模式.....................................................................................................15 第四章 典型案例的分析.............................................................................16 4.1 医中有养模式：海南海口恭和苑案例分析........................................................16 4.2 养中有医模式：蒙阴托福太阳城案例分析........................................................18 4.3 居家巡诊模式：山东费县案例分析....................................................................20 第五章 蒙阴县医养结合产业发展分析.....................................................25 5.1 客观形势政策.......................................................................................................25 5.1.1 发展形势.......................................................................................................25 5.1.2 政策现状.......................................................................................................25 5.2 蒙阴县医养结合产业 SWOT 分析......................................................................27 5.3 蒙阴县医养结合产业五力模型分析...................................................................31 第六章 蒙阴县医养结合产业发展战略与保障措施................................32 6.1 蒙阴县医养结合产业发展战略...........................................................................32 6.1.1 适当发展医中有养产业模式.......................................................................32 6.1.2 适当发展养中有医产业模式.......................................................................32 6.1.3 依托家庭医生服务和社区服务发展居家巡诊产业模式...........................33 6.1.4 适当发展和拓展医养+产业模式.................................................................34 6.2 蒙阴医养结合产业发展战略的保障措施...........................................................35 6.2.1 组织管理保障................................................................................................35 6.2.2 社会保险保障................................................................................................35 6.2.3 土地、财政、行政保障................................................................................36 6.2.4 人才队伍保障................................................................................................36 6.2.5 舆论宣传保障................................................................................................36 第七章 总结与展望.....................................................................................37 7.1 研究工作总结........................................................................................................37 7.2 研究展望................................................................................................................37