Since China entered an aging society at the end of the 20th century, the number and proportion of the elderly population in the total population have continued to grow. From 2000 to 2019, the population aged 60 and over increased from 126 million to 253.88 million, and the proportion of the elderly population in the total population increased from 10.2% to 18.1%.

In order to cope with the aging trend, in 2019, the CPC Central Committee and the State Council issued the national medium and long term plan for actively responding to population aging, which proposed to improve the multi-level elderly care service system based on home, community, full development of institutions and organic combination of medical care, expand the supply of elderly products and services in multiple channels and fields, and improve the quality of products and services.

The Fifth Plenary Session of the 19th CPC Central Committee proposed to "implement the national strategy to actively respond to population aging". The proposal of the CPC Central Committee on formulating the 14th five-year plan for national economic and social development and the long-term goal for 2035 adopted at the plenary session proposed to develop inclusive pension services and mutual pension, support families to undertake pension functions, and cultivate new forms of pension, We will build an elderly care service system in which home-based community institutions coordinate and medical care and health care are combined, and improve the comprehensive supervision system of elderly care services.

How to implement the national strategy to actively respond to population aging? How to build a multi-level elderly care service system? How to further expand the supply of elderly care services? The people's Daily reporter conducted an investigation and interview.

Home, community and institutional elderly care work together, "no fence" professional services to improve the quality of life of the elderly

It was sunny in autumn. The 86 year old Liu Haifang and his old friends were walking and chatting in the yard. This is the social welfare center of Qingshanhu District, Nanchang City, Jiangxi Province, the second batch of pilot units for the reform of public elderly care institutions determined by the Ministry of civil affairs and the national development and Reform Commission. It is invested and constructed by the local government and operated and managed by Zhejiang lvkang medical care group.

"Settle down here!" A few months ago, Liu Haifang and his wife came here and didn't want to leave as soon as they lived. Liu Haifang said, "the older we get, the worse our physical strength is. It's more difficult to buy vegetables, cook and do housework. There's ready-made food here. The room is cleaned. Let's take a walk and read books. It's more comfortable."

Zhou Chenghai, President of the welfare center, introduced that there are 660 nursing beds and 428 medical nursing beds in the hospital. The food, accommodation and medical conditions are good. The spiritual life of the elderly is also rich and colorful. You can go to the reading room to read books and newspapers, and often hold dances and song parties to enjoy the old.

Institutional elderly care is good at professional services, and the elderly live at ease. However, in China, like Liu Haifang, the elderly living in nursing homes are still a minority. More than 90% of the elderly still choose home and community elderly care. The picture is "relatives and friends often meet and live more freely".

Can you get professional care for the elderly at home and in the community? The reporter visited Yuetan Street, Xicheng District, which first practiced the "community pension post station" in Beijing.

Grandma Jiang, 86, lives in Qibei community, Yuetan Street. More than 10 years ago, she suffered from intracerebral hemorrhage. Her legs and feet didn't listen to her orders. It was difficult to get out of the door. Eating and bathing became even more problems.

"Thanks to 'daughter' Xiao Ren, I only look for her if there are any difficulties." Mrs. Jiang's little Ren, named Ren Wuying, is a professional nurse in the old-age post station of Qibei community. She accompanied Mrs. Jiang through the low times and forged deep friendship in the long-term care. "On call, put down your job and run over. It's more pro than your daughter!" Grandma Jiang said.

This elderly care post station is a site under the management of Yuetan "no fence" nursing home. It advocates "limited space and unlimited service", and provides elderly care in the community and at home for the elderly by introducing professional elderly care institutions, housekeeping, business supermarkets, volunteer organizations and other platforms. In 2019 alone, nine post stations in the street provided more than 160000 services such as daytime care, accompanying medical treatment, meal and bath assistance, cultural and recreational activities for the elderly in 26 communities under the jurisdiction.

"Some communities have a large elderly population, few elderly care resources and relatively low income for the elderly. It is a big problem to meet the needs of residents for elderly care services. Now home-based elderly care and community and institutional elderly care complement each other, so that the problem can be solved." Yu Rui, deputy director of Yuetan Street Public Service Center, said.

The exploration of "community elderly care post station" in Beijing outlines the outline of the future elderly care service system with Chinese characteristics——

"From the supply side, improving the multi-level elderly care service system can make home, community and institutional elderly care services give better play to their respective advantages and complementary functions, and firmly weave a dense elderly care service network." Li Zhihong, director of Policy Research Department of China Aging Association, believes that strengthening the coordination of elderly care services at all levels will help the elderly enjoy comprehensive and continuous elderly care services.

From the demand side, there are great differences in the elderly care service needs of the elderly with different income levels, family structure and health status. Zhu Ming, director of the health economy and medical security research center of Nankai University, said that the elderly who can take care of themselves will generally provide for the elderly at home or go to the community to meet their needs for food, medical treatment and entertainment; The elderly with increased disability need the care of professional institutions.

From a longer perspective, improving the multi-level elderly care service system can drive the "silver economy" and smooth the domestic economic cycle. He Xiaofeng, chairman of everyone insurance group, believes that building a multi-level pension service system has great potential in meeting pension needs and absorbing employment. Vigorously developing pension services is not only an important measure to strengthen the bottom line of people's livelihood, but also an important focus to support the domestic cycle.

Combination of medical care and nursing

Increase convenience for "elderly care with illness"

Save medical resources, revitalize idle resources and fill the shortage of elderly care services

In 2019, more than 180 million elderly people in China suffered from chronic diseases, and the proportion of suffering from one or more chronic diseases reached 75%. Wang Haidong, director of the aging health department of the National Health Commission, said that China's per capita life expectancy has reached 77 years old, but there are still problems such as high prevalence and survival with disease.

How to improve the quality of life of the elderly? The combination of medical care and nursing care is a good way.

At present, there are three main modes of medical support combination in China: elderly care institutions add medical services, medical institutions expand elderly care services, and integrate medical support resources at home and in the community to make medical services enter the home and the community.

For the combination of medical care and nursing care in elderly care institutions, grandma Wu, a 76 year old Beijing resident, has a deep experience, "I'm an old patient with coronary heart disease and cerebral infarction." Six years ago, she moved into the Dongli nursing home in Changping District. The Beijing longfu hospital separated by a wall dispelled her concern about "what to do when she gets sick": the nursing home cooperates with the hospital, so she can see a doctor when she goes out and swipe her medical insurance card directly, which is very convenient.

A month ago, grandma Wu suddenly had difficulty speaking and choked her throat when drinking water. After knowing her medical history, the doctors of Longfu hospital quickly arranged CT and MRI. Sure enough, there was a slight cerebral infarction. Fortunately, she was found early and treated in time, and her ability to move was hardly impaired. "If you don't want to sleep in the ward at night, go back to the nursing home to sleep. Look, this is called the combination of medical care and maintenance!" Grandma Wu said with a smile.

Huang Wuxiang, who lives in Yichun elderly nursing home in Jiangxi Province, praised the elderly care services provided by medical institutions: "the nursing home is located in the small garden of the municipal Third People's hospital. Every day when it's time to give oxygen treatment, the nurse comes to my room, after giving oxygen, and then plays cards and chats with everyone without delay."

"Treat the sick and provide for the aged without illness." Du Xiaohong, vice president of the nursing home for the elderly, said that the establishment of the nursing home for the elderly by the hospital has professional advantages and can provide medical rehabilitation, life care, spiritual care and other services for the elderly.

More elderly people stay in the community to receive integrated medical care services. A few days ago, the reporter came to xiaocixuan elderly care service center, a beautiful home on Donghu West Road, Yuexiu District, Guangzhou. She happened to meet Wen Xiaoni, a doctor from Baiyun Street Community Health Service Center, to examine Yu Shixiong, 94. "Xiongbo, blood sugar has been controlled well recently. Keep it up!" Wen Xiaoni turned and told the nurse, "from today on, his insulin can play four units less."

"The average age of the elderly here is 87, and many people suffer from chronic diseases." Li Min, vice president of East Lake West xiaocixuan, introduced that in order to strengthen the combination of medical care and maintenance, xiaocixuan signed a service agreement with Baiyun Street Community Health Service Center and cooperated with the nearby third class hospitals such as Guangdong Provincial People's hospital. Once the elderly have a critical illness, they will take the "green channel" for rapid referral.

Industry insiders believe that the combination of medical care and maintenance has multiple economic and social benefits.

First, it is conducive to the optimal allocation of medical and elderly care resources. Cai Fei, deputy director of the aging health department of the National Health Commission, said that a single medical and pension system is difficult to meet the health and pension needs of the elderly. The combination of medical and pension can integrate health and pension resources and improve the accessibility of medical and health services for the elderly.

"On the one hand, the combination of medical care and support can reduce the long-term 'pressure' of the disabled elderly in large hospitals and save valuable medical resources; on the other hand, it can revitalize the idle resources of some nursing homes and small and medium-sized hospitals and balance the supply-demand relationship between medical care and support." Zheng Wei, director of the Department of risk management and insurance, School of economics, Peking University, said.

Secondly, the combination of medical care and social benefits is obvious. Lu Yanli, President of Beijing longfu hospital, believes that more than 90% of the elderly in China choose home and community elderly care. The combination of medical care and elderly care can reduce the care burden of their children, reduce the worries of the disabled elderly and their families, and help maintain family harmony and social stability.

Third, the combination of medical care and nursing also has long-term economic benefits. Tao Wenzhong, director of the labor relations research center of Capital University of economics and trade, said that the combination of medical care and nursing lengthens the health and elderly care industry chain and can promote the development of care facilities, smart elderly care and other related products and services.

"The combination of medical care and nursing industry is not only a knowledge intensive industry, but also a labor-intensive industry. With strong social participation and many jobs, it is an important economic growth point under the new development pattern." Cai Fei said.

Source: People's daily