英国医养结合试点经验:以伦敦哈罗镇为例
|
摘要
现阶段,老龄化社会是全球很多国家和地区面临的重大问题,医养结合是老龄化国家针对老年公共服务中医疗服务和社会照护间而进行资源整合的一套方法。国内医养结合目前尚在起步和摸索阶段,而英国具有完善的医疗和养老服务体系。笔者主要就英国医疗服务体系、老年人养老与护理、医养结合情况进行论述,并从坚持政府主导,统筹协调现有医疗和社会服务资源;医疗和社会服务设立共同基金,专门推动医养结合;设立明确的医养结合目标;多部门参与,共同决策;以病人为中心,为患者赋权等方面阐述了对国内医养结合工作进一步开展提供借鉴。
At present, the aging society is a major problem in many countries, and the combination of elderly care is a set of methods and tools for the aging countries to integrate medical care and social care in the elderly care. The elderly care in China is still in the starting stage, and the UK has a perfect National Health Service System. This paper mainly discusses the UK healthcare system, the elderly care and nursing and its combination. Experiences can be referred such as integrating healthcare and social service resources under government regulation, setting earmarked joint funds promoting the integration of healthcare and elderly care by NHS and social service institutes, clearing goals and all rounds participation, patient oriented care and patient participation have been analyzed.
At present, the aging society is a major problem in many countries, and the combination of elderly care is a set of methods and tools for the aging countries to integrate medical care and social care in the elderly care. The elderly care in China is still in the starting stage, and the UK has a perfect National Health Service System. This paper mainly discusses the UK healthcare system, the elderly care and nursing and its combination. Experiences can be referred such as integrating healthcare and social service resources under government regulation, setting earmarked joint funds promoting the integration of healthcare and elderly care by NHS and social service institutes, clearing goals and all rounds participation, patient oriented care and patient participation have been analyzed.
引文
[1]Randall M.Overview of the uk population:July 2017[M].London:Office for National Statistics,2017.
[2]Slack P.The english poor law,1531-1782[M].Cambridge:Cambridge University Press,1995.
[3]王莉莉,吴子攀.英国社会养老服务建设与管理的经验与借鉴[J].老龄科学研究,2014(7):61-70.
[4]NHS Digital.Personal social services:Expenditure and unit costs england,2012-2013[R/OL].London:Health and Social Care Information Centre,2013[2018-02-26].h ttps://digit a l.nh s.uk/d ataand-information/publications/statistical/personal-social-services-expenditureand-unit-costs/personal-social-servicesexpenditure-and-unit-costs-england-2012-13-final-release#resources.
[5]HM Treasury.Country and regional analysis 2013[R/OL].London:HM Treasury,2013[2018-01-26].https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/264286/Country_and_Regional_Analysis_2013.pdf.
[6]Department of Health.2011-12programme budgeting benchmarking[R/OL].London:Department of Health,2012[2018-01-26]https://www.networks.nhs.uk/nhs-networks/health-investment-network/doc um e n ts/2011-12%2 0P r ogr amme%2 0Budgeting%20Benchmarking%20Tool_FINAL.zip/view.
[7]Laing Buisson.Domiciliary care:Uk market report 2013[R/OL].London:Laing Buisson,2013[2018-01-26].https://w w w.l a i n g b u i s s o n.c o m/w p-c o n t e n t/uploads/2016/06/Dom_Care13_bro_WEB.pdf.
[8]Carers UK.Valuing carers 2011[R/OL].London:Carers UK,2011[2018-06-26].https://www.carersuk.org/about-us/36-for-professionals/policy-eng/report/5021-valuing-carers-2011-calculating-the-valueof-carers-support.
[9]Skills for Care.The economic value of the adult social care sector in england.Leeds:Skills for Care[R/OL],2013[2018-08-03].https://www.skillsforcare.org.uk/About/Skills-for-Care-and-Development/The-economic-value-of-the-adult-socialcare-sector-UK.aspx.
[10]National Council for Voluntary Organisation.2010-11 uk estimate for adult and children’s social services combined[R].London:National Council for Voluntary Organisations,2013.
[11]NAO.Adult social care in england:Overview[R/OL].London:The Stationery O f f i c e L i m i t e d,2 0 1 4[2 0 1 8-0 6-0 3].https://www.nao.org.uk/wp-content/uploads/2015/03/Adult-social-care-inEngland-overview.pdf.
[12]NHS.Introduction to care and support[EB/OL].London:NHS,2018[2018-09-28].https://www.nhs.uk/conditions/social-care-and-support-guide/.
[13]甘雪琼,赵明刚,郭燕红,等.英国的医疗质量监管体系及启示[J].中国医疗管理科学,2015,5(5):43-47.
[14]Impower Consulting.Working with gps to reduce demand on health and social care[R].London:Impower Consulting Ltd,2013.
[15]Forder J.Consequences of local variations in social care on the performance of the acute health care sector[J].Applied Economics,2008,40(12):1503-1518.
[16]National Audit Office.Improving dementia services in England-an interim report,session 2009-10,hc 82[R/OL].London:The Stationery Office Limited,2010[2018-09-28].https://publications.parliament.uk/pa/cm200910/cmselect/cmpubacc/321/321.pdf.
[17]National Audit Office.Services for people with rheumatoid arthritis,session2008-09,hc 823[R].London:The Stationery Office Limited,2009.
[18]National Audit Office.Supporting people with autism through adulthood,session 2008-09,hc 125[R/OL].London:The Stationery Office Limited,2009[2018-08-30].https://publications.parliament.uk/pa/cm200809/cmselect/cmpubacc/697/697.pdf.
[19]National Audit Office.End of life care,session 2007-08,hc 1043[R/OL].London:The Stationery Office Limited,2008[2018-11-20].https://www.nao.org.uk/wp-content/uploads/2008/11/07081043.pdf.
[20]Department of Health and Social Care.Health and social care act 2012:Fact sheets[R/OL].London:Department of Health and Social Care,2012[2018-09-20].https://www.gov.uk/government/publications/health-and-social-care-act-2012-fact-sheets.
[21]Department of Health and Social Care.Care act factsheets[R/OL].London:Department of Health&Social Care,2016[2018-10-23].https://www.gov.uk/government/publications/care-act-2014-part-1-factsheets/care-act-factsheets.
[22]BCF.Better care fund:Policy framework[R/OL].DOH(ed).London:Department of Health,2014[2018-08-24].h t t p s://as s e t s.p u b l i s h i n g.s e r v i c e.g o v.uk/government/uploads/system/uploads/attachment_data/file/381848/BCF.pdf.
[23]Paul Najsarek RL.Update on whole systems integrated care programme[M].London:Harrow Health and Wellbeing Board,2014.
[24]Bob Erens GW,Sandra MounierJack,Nick Douglas.Early evaluation of the integrated care and support pioneers programme final report[M].London:PIRU,2016.
[25]Whiting S.Harrow and brent system resilience group(srg)[M].London:Harrow Health and Wellbeing Board,2016.
[26]Gerald Wistow MG,Holly Holder and Judith Smith.Putting integrated care into practice:The north west london experience[M].London:Nuffield Trust,2015.
[27]Wsic programme a common outcomes framework.London:Harrow Council,2017.
[28]Sehgal J.Information report:Whole systems integrated care update report[M].London:Harrow Health and Wellbeing Board,2015.
[29]Harrow Council.Harrow better care fund plan:Outline plan 2016/17[R/OL].London:Harrow Council,2016[2018-07-28].https://www.harrow.gov.uk/www2/documents/s134335/Harrow%20Better%20Care%20Fund%20Plan%20Final%201617.pdf.
[2]Slack P.The english poor law,1531-1782[M].Cambridge:Cambridge University Press,1995.
[3]王莉莉,吴子攀.英国社会养老服务建设与管理的经验与借鉴[J].老龄科学研究,2014(7):61-70.
[4]NHS Digital.Personal social services:Expenditure and unit costs england,2012-2013[R/OL].London:Health and Social Care Information Centre,2013[2018-02-26].h ttps://digit a l.nh s.uk/d ataand-information/publications/statistical/personal-social-services-expenditureand-unit-costs/personal-social-servicesexpenditure-and-unit-costs-england-2012-13-final-release#resources.
[5]HM Treasury.Country and regional analysis 2013[R/OL].London:HM Treasury,2013[2018-01-26].https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/264286/Country_and_Regional_Analysis_2013.pdf.
[6]Department of Health.2011-12programme budgeting benchmarking[R/OL].London:Department of Health,2012[2018-01-26]https://www.networks.nhs.uk/nhs-networks/health-investment-network/doc um e n ts/2011-12%2 0P r ogr amme%2 0Budgeting%20Benchmarking%20Tool_FINAL.zip/view.
[7]Laing Buisson.Domiciliary care:Uk market report 2013[R/OL].London:Laing Buisson,2013[2018-01-26].https://w w w.l a i n g b u i s s o n.c o m/w p-c o n t e n t/uploads/2016/06/Dom_Care13_bro_WEB.pdf.
[8]Carers UK.Valuing carers 2011[R/OL].London:Carers UK,2011[2018-06-26].https://www.carersuk.org/about-us/36-for-professionals/policy-eng/report/5021-valuing-carers-2011-calculating-the-valueof-carers-support.
[9]Skills for Care.The economic value of the adult social care sector in england.Leeds:Skills for Care[R/OL],2013[2018-08-03].https://www.skillsforcare.org.uk/About/Skills-for-Care-and-Development/The-economic-value-of-the-adult-socialcare-sector-UK.aspx.
[10]National Council for Voluntary Organisation.2010-11 uk estimate for adult and children’s social services combined[R].London:National Council for Voluntary Organisations,2013.
[11]NAO.Adult social care in england:Overview[R/OL].London:The Stationery O f f i c e L i m i t e d,2 0 1 4[2 0 1 8-0 6-0 3].https://www.nao.org.uk/wp-content/uploads/2015/03/Adult-social-care-inEngland-overview.pdf.
[12]NHS.Introduction to care and support[EB/OL].London:NHS,2018[2018-09-28].https://www.nhs.uk/conditions/social-care-and-support-guide/.
[13]甘雪琼,赵明刚,郭燕红,等.英国的医疗质量监管体系及启示[J].中国医疗管理科学,2015,5(5):43-47.
[14]Impower Consulting.Working with gps to reduce demand on health and social care[R].London:Impower Consulting Ltd,2013.
[15]Forder J.Consequences of local variations in social care on the performance of the acute health care sector[J].Applied Economics,2008,40(12):1503-1518.
[16]National Audit Office.Improving dementia services in England-an interim report,session 2009-10,hc 82[R/OL].London:The Stationery Office Limited,2010[2018-09-28].https://publications.parliament.uk/pa/cm200910/cmselect/cmpubacc/321/321.pdf.
[17]National Audit Office.Services for people with rheumatoid arthritis,session2008-09,hc 823[R].London:The Stationery Office Limited,2009.
[18]National Audit Office.Supporting people with autism through adulthood,session 2008-09,hc 125[R/OL].London:The Stationery Office Limited,2009[2018-08-30].https://publications.parliament.uk/pa/cm200809/cmselect/cmpubacc/697/697.pdf.
[19]National Audit Office.End of life care,session 2007-08,hc 1043[R/OL].London:The Stationery Office Limited,2008[2018-11-20].https://www.nao.org.uk/wp-content/uploads/2008/11/07081043.pdf.
[20]Department of Health and Social Care.Health and social care act 2012:Fact sheets[R/OL].London:Department of Health and Social Care,2012[2018-09-20].https://www.gov.uk/government/publications/health-and-social-care-act-2012-fact-sheets.
[21]Department of Health and Social Care.Care act factsheets[R/OL].London:Department of Health&Social Care,2016[2018-10-23].https://www.gov.uk/government/publications/care-act-2014-part-1-factsheets/care-act-factsheets.
[22]BCF.Better care fund:Policy framework[R/OL].DOH(ed).London:Department of Health,2014[2018-08-24].h t t p s://as s e t s.p u b l i s h i n g.s e r v i c e.g o v.uk/government/uploads/system/uploads/attachment_data/file/381848/BCF.pdf.
[23]Paul Najsarek RL.Update on whole systems integrated care programme[M].London:Harrow Health and Wellbeing Board,2014.
[24]Bob Erens GW,Sandra MounierJack,Nick Douglas.Early evaluation of the integrated care and support pioneers programme final report[M].London:PIRU,2016.
[25]Whiting S.Harrow and brent system resilience group(srg)[M].London:Harrow Health and Wellbeing Board,2016.
[26]Gerald Wistow MG,Holly Holder and Judith Smith.Putting integrated care into practice:The north west london experience[M].London:Nuffield Trust,2015.
[27]Wsic programme a common outcomes framework.London:Harrow Council,2017.
[28]Sehgal J.Information report:Whole systems integrated care update report[M].London:Harrow Health and Wellbeing Board,2015.
[29]Harrow Council.Harrow better care fund plan:Outline plan 2016/17[R/OL].London:Harrow Council,2016[2018-07-28].https://www.harrow.gov.uk/www2/documents/s134335/Harrow%20Better%20Care%20Fund%20Plan%20Final%201617.pdf.