康养融合,应对老龄化社会新战略
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摘要
为解决老龄化社会带来的困境,我国积极推进医养结合,康复养老融合可能成为康复医学学科发展的突破口。根据国外的3种发展模式与我国现状,康复养老融合的关键点是以家庭、社区、机构为依托,提供专业康复手段改善老年人功能,以达到"愉快地老去、有尊严地老去"。并以健全的保险制度为保障、"三元论"康复理论为指导,借人工智能、大数据云平台打造中国三级"智慧康复养老"体系为战略方向。
In order to solve the predicament brought by the aging society, China has promoted the combination of medical care. Hence, rehabilitation for the elderly may become a new strategy for the development of rehabilitation. According to the development of three different models and situation of China, we focus on improving the function of the elderly based on the families, the communities and institutions. Finally, the elderly feel happy and respected by getting professional means of rehabilitation while aging. The insurance system is the guarantee of promoting rehabilitation for the elderly and the "ternary theory" rehabilitation theory should be the guide concept. In the future, the trend is to build China's three-level "intelligent rehabilitation for the elderly system" by artificial intelligence and big data cloud platform.
In order to solve the predicament brought by the aging society, China has promoted the combination of medical care. Hence, rehabilitation for the elderly may become a new strategy for the development of rehabilitation. According to the development of three different models and situation of China, we focus on improving the function of the elderly based on the families, the communities and institutions. Finally, the elderly feel happy and respected by getting professional means of rehabilitation while aging. The insurance system is the guarantee of promoting rehabilitation for the elderly and the "ternary theory" rehabilitation theory should be the guide concept. In the future, the trend is to build China's three-level "intelligent rehabilitation for the elderly system" by artificial intelligence and big data cloud platform.
引文
1国务院人口普查办公室国家统计局人口和就业统计司.中国2010年人口普查资料.[2019-05-04]. http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
2全国老龄工作委员办公室.国家统计局:老龄化程度加深劳动年龄人口数量连降7年.(2019-01-24)[2019-05-04]. http://www.cncaprc.gov. cn/contents/2/188549.html.
3国务院办公厅.《国务院办公厅转发卫生计生委等部门关于推进医疗卫生与养老服务相结合指导意见的通知》(国办发[2015]84号).(2015-11-18)[2019-05-04]. http://www.gov.cn/zhengce/content/2015-11/20/content_10328.htm.
4 Offenbacher M, Sauer S, Hieblinger R, et al. Spirituality and the international classification of functioning, disability and health:content comparison of questionnaires measuring mindfulness based on the international classification of functioning. Disabil Rehabil, 2011, 33(25/26):2434-2445.
5唐飞泉,杨律铭.我国医养结合模式探索和创新.现代管理科学,2018(12):51-53.
6许文丽,刘化侠,杨朝霞,等.社区老年人医养康护一体化服务需求及影响因素研究.中国实用护理杂志,2019, 35(6):451-456.
7黄晓琳,燕铁斌.康复医学.5版,北京:人民卫生出版社,2013:1.
8 M'kumbuzi VR, Myezwa H. Adaptation of the global frameworks for community based rehabilitation in southern Africa:a proof ofconcept. Rural Remote Health, 2017,17(3):3717.
9 Dengsoe C, Rohde L. Higher pensions and less risk:innovation at Denmark's ATP pension plan. Rotman Int J Pension Management,2010.
10 Vass M, Avlund K, Hendriksen C, et al. Preventive home visits to older people in Denmark:methodology of a randomized controlled study. Aging Clin Exp Res, 2002, 14(6):509-515.
11 Lewinter M. Developments in home help for elderly people in Denmark:the changing concept of home and institution. Int J Soc Welf, 2004,13(1):89-96.
12 Gillam S. Public and private roles in health care systems:reform experience in seven OECD countries. Family Practice, 2002,19(3):311.
13 Haas LEM, van Beusekom I, van Dijk D, et al. Healthcare-related costs in very elderly intensive care patients. Intensive Care Med,2018,44(11):1896-1903.
14 Centers for Disease Control and Prevention. Healthy places terminology.(2019-03-09)[2019-05-04]. https://www.cdc.gov/healthyplaces/terminology.htm#a.
15曾迎霄.美国自然形成退休社区养老服务模式及启示.河南牧业经济学院学报,2016, 29(5):52-54.
16周驰,孟凡莉.美国持续照料退休社区的健康管理模式及启示.中国老年学杂志,2017, 37(2):518-519.
17张悦玲,解聪.国外农村养老模式有何特色.人民论坛,2017(3):118-119.
18 Wick JY. Aging in place:our house is a very, very, very fine house.Consult pharm,2017, 32(10):566-574.
19 Mardini MT, Iraqi Y, Agoulmine N. A survey of healthcare monitoring systems for chronically ill patients and elderly. J Med Syst, 2019,43(3):50.
20 Danilovich MK, Diaz L, Saberbein G, et al. Design and development of a mobile exercise application for home care aides and older adult medicaid home and community-based clients.Home Health Care Serv Q, 2017, 36(3-4):196-210.
21 Vanleerberghe P, De Witte N, Claes C, et al. The quality of life of older people aging in place:a literature review. Qual Life Res, 2017,26(11):2899-2907.
22 Steihaug S, Lippestad JW, Werner A. Between ideals and reality in home-based rehabilitation. Scand J Prim Health Care, 2016, 34(1):46-54.
29中西杨华.日本康复养老运营模式借鉴.城市开发,2018(11):49.
24 Ayalon L. Between older adults'needs and the law:the Israeli Long Term Care Insurance Law from the perspectives of service users and providers. Health Soc Care Community, 2018, 26(4):e514-e522.
25 Brodsky J, Habib J, Mizrahi I. Long-term care laws in five developed countries:a review.(2000-09)[2019-05-04].https://apps.who.int/iris/bitstream/handle/10665/66572/WHO_N MH_CCL_00.2.pdf?sequence=1&isAllowd=y.
26 Hatano E. Long-term care insurance in Japan:how physicians are involved in providing rehabilitation for the elderly. Japan Med Assoc J, 2012, 55(3):231-239.
27李佳婧.日本养老设施康复景观设计实例分析//中国园艺疗法学术研究会议北京大会暨第一届园艺疗法与康复景观高峰论坛暨学术研讨会论文集.北京:中国社会工作联合会,2015:261-268.
28 Arai H, Ouchi Y, Toba K, et al.Japan as the front-runner of superaged societies:perspectives from medicine and medical care inJapan. Geriatr Gerontol Int, 2015, 15(6):673-687.
29 Sackley CM, van den Berg ME, Lett K, et al. Effects of a physiotherapy and occupational therapy intervention on mobility and activity in care home residents:a cluster randomized controlled trial. BMJ, 2009, 339:b3123.
30 Krist L, Dimeo F, Keil T. Can progressive resistance training twice a week improve mobility, muscle strength, and quality of life in very elderly nursing-home residents with impaired mobility?A pilot study. Clin Interv Aging, 2013, 8:443-448.
31 De Coninck L, Bekkering GE, Bouckaert L, et al. Home-and community-based occupational therapy improves functioning in frail older people:a systematic review. J Am Geriatr Soc, 2017,65(8):1863-1869.
32 Forster A, Lambley R, Young JB. Is physical rehabilitation for older people in long-term care effective? Findings from a systematic review. Age Ageing, 2010, 39(2):169-175.
33汤军克,陈林利,陈建平.居家养老老年人日常生活活动能力及其影响因素.中国康复理论与实践,2012,18(4):372-375.
34丁琳,周婷.中国老年人康复护理和养老概况及分析.中国保健营养,2017, 27(23):187-188.
35姚瑞山,柯永红,袁晓晓,等.我国社区居家养老的现状及分析.全科护理,2012, 10(32):3055-3057.
36吕鹏飞,陈晓玲,周宏东,等.上海市医养结合养老模式卫生监督困境及对策.医学与社会,2016, 29(2):71-73.
37向钊娣.居家养老康复期老年人照护所需专职人员//国际老年健康论坛·泰山论文集.西安:西安市碑林区老年学学会,2016:357-358.
38唐路生.人口老龄化背景下的居家运动健康服务现状调查——以武汉市为例.武汉:华中师范大学,2016:33-36.
39张程远.我国持续照护型养老社区医疗康复区规划与设计研究.重庆:重庆大学,2018:26-27.
40杨晨.佛山市南海区“医养结合”康复养老模式研究.长沙:湖南大学,2018:24.
41郑洁皎.上海康复医疗服务体系中建立老年康复模式探索与研究//中国康复医学会第七次全国老年医学与康复学术大会论文集.哈尔滨:中国康复医学会老年健康专业委员会,2012:43-46.
42卓永岳.绿康康复养老模式的创新实践//2011年浙江省物理医学与康复学学术年会论文集.浙江:浙江省医师协会,2011:129-131.
43孙茜.中医“十三五”规划路:康复+养老.中国医院院长,2016(19):30-31.
44夏家红.武汉市“医养结合”模式评析.长江论坛,2014(6):41-43.
45王斌.公立医院为主体的机构养老探索上海君莲养老院及失智老人康复治疗中心方案介绍.时代建筑,2012(6):64-65.
46于涛,王昊,余海瑞,等.天津市部分养老院康复医疗现状及服务需求.中国康复医学杂志,2016, 31(1):77-79.
47许扬.医养结合养老机构发展困境及对策研究——以J县N养老康复中心为例.保定:河北大学,2017:11-13.
48管国富.常州社区老年人慢病康复养老服务基本情况及建议.江苏卫生事业管理,2011,22(4):101-103.
49罗治安,罗清平,罗云,等.养老机构老年人康复服务现状及对康复人才需求的调查研究.中国康复医学杂志,2018, 33(9):1081-1086.
50黄东,高阳.关于加快发展公办民营养老机构的思考——以宿迁市虹枫老年公寓为例.江苏经贸职业技术学院学报,2016(5):36-39.
51王声菲.康复花园设计策略研究——以杭州地区养老机构为例.杭州:浙江农林大学,2017:12-17.
52邵娜.医养结合模式下养老机构医疗康复空间的设计研究.丝路视野,2017(33):181.
53缪金萍,周静,孙丽芳,等.常州市养老机构康复服务开展现状调查分析.卫生职业教育,2018, 36(8):145-146.
54张利苹,化前珍,杨波,等.西安市养老机构康复服务现况及康复需求调查.护理研究,2018, 32(4):594-596.
55黄如意,胡善菊.山东省医养结合模式发展的SWOT分析.中国卫生事业管理,2016, 33(2):145-147.
56陈卓铭,陈玉美,赵志峰,等.围绕校园社区的三级医院主导下的医养康养老服务.社会福利(理论版),2016(10):28-31.
57汪结胜,胡仁美.一种基于互联网技术的居家养老智慧云系统:中国,CN108492850A,2018-03-13.
58孙艳玲,张伟,耿慧.云南省中医药健康O2O社区养老服务平台研究.中国医药导报,2018, 15(29):152-156.
59田帝,章豪,周典.基于大数据的老年人居家养老云服务平台构建策略.中国老年学杂志,2019, 39(7):1784-1789.
60李杰.青岛“医养结合”养老模式问题研究.中国人力资源开发,2014(18):74-80.
61王玉龙,陈晓峰,肖鹏,等.深圳市“医保康复养老”模式的开展及探索//中国康复医学会第七次全国老年医学与康复学术大会论文集.哈尔滨:中国康复医学会老年健康专业委员会,2012:36-38.
2全国老龄工作委员办公室.国家统计局:老龄化程度加深劳动年龄人口数量连降7年.(2019-01-24)[2019-05-04]. http://www.cncaprc.gov. cn/contents/2/188549.html.
3国务院办公厅.《国务院办公厅转发卫生计生委等部门关于推进医疗卫生与养老服务相结合指导意见的通知》(国办发[2015]84号).(2015-11-18)[2019-05-04]. http://www.gov.cn/zhengce/content/2015-11/20/content_10328.htm.
4 Offenbacher M, Sauer S, Hieblinger R, et al. Spirituality and the international classification of functioning, disability and health:content comparison of questionnaires measuring mindfulness based on the international classification of functioning. Disabil Rehabil, 2011, 33(25/26):2434-2445.
5唐飞泉,杨律铭.我国医养结合模式探索和创新.现代管理科学,2018(12):51-53.
6许文丽,刘化侠,杨朝霞,等.社区老年人医养康护一体化服务需求及影响因素研究.中国实用护理杂志,2019, 35(6):451-456.
7黄晓琳,燕铁斌.康复医学.5版,北京:人民卫生出版社,2013:1.
8 M'kumbuzi VR, Myezwa H. Adaptation of the global frameworks for community based rehabilitation in southern Africa:a proof ofconcept. Rural Remote Health, 2017,17(3):3717.
9 Dengsoe C, Rohde L. Higher pensions and less risk:innovation at Denmark's ATP pension plan. Rotman Int J Pension Management,2010.
10 Vass M, Avlund K, Hendriksen C, et al. Preventive home visits to older people in Denmark:methodology of a randomized controlled study. Aging Clin Exp Res, 2002, 14(6):509-515.
11 Lewinter M. Developments in home help for elderly people in Denmark:the changing concept of home and institution. Int J Soc Welf, 2004,13(1):89-96.
12 Gillam S. Public and private roles in health care systems:reform experience in seven OECD countries. Family Practice, 2002,19(3):311.
13 Haas LEM, van Beusekom I, van Dijk D, et al. Healthcare-related costs in very elderly intensive care patients. Intensive Care Med,2018,44(11):1896-1903.
14 Centers for Disease Control and Prevention. Healthy places terminology.(2019-03-09)[2019-05-04]. https://www.cdc.gov/healthyplaces/terminology.htm#a.
15曾迎霄.美国自然形成退休社区养老服务模式及启示.河南牧业经济学院学报,2016, 29(5):52-54.
16周驰,孟凡莉.美国持续照料退休社区的健康管理模式及启示.中国老年学杂志,2017, 37(2):518-519.
17张悦玲,解聪.国外农村养老模式有何特色.人民论坛,2017(3):118-119.
18 Wick JY. Aging in place:our house is a very, very, very fine house.Consult pharm,2017, 32(10):566-574.
19 Mardini MT, Iraqi Y, Agoulmine N. A survey of healthcare monitoring systems for chronically ill patients and elderly. J Med Syst, 2019,43(3):50.
20 Danilovich MK, Diaz L, Saberbein G, et al. Design and development of a mobile exercise application for home care aides and older adult medicaid home and community-based clients.Home Health Care Serv Q, 2017, 36(3-4):196-210.
21 Vanleerberghe P, De Witte N, Claes C, et al. The quality of life of older people aging in place:a literature review. Qual Life Res, 2017,26(11):2899-2907.
22 Steihaug S, Lippestad JW, Werner A. Between ideals and reality in home-based rehabilitation. Scand J Prim Health Care, 2016, 34(1):46-54.
29中西杨华.日本康复养老运营模式借鉴.城市开发,2018(11):49.
24 Ayalon L. Between older adults'needs and the law:the Israeli Long Term Care Insurance Law from the perspectives of service users and providers. Health Soc Care Community, 2018, 26(4):e514-e522.
25 Brodsky J, Habib J, Mizrahi I. Long-term care laws in five developed countries:a review.(2000-09)[2019-05-04].https://apps.who.int/iris/bitstream/handle/10665/66572/WHO_N MH_CCL_00.2.pdf?sequence=1&isAllowd=y.
26 Hatano E. Long-term care insurance in Japan:how physicians are involved in providing rehabilitation for the elderly. Japan Med Assoc J, 2012, 55(3):231-239.
27李佳婧.日本养老设施康复景观设计实例分析//中国园艺疗法学术研究会议北京大会暨第一届园艺疗法与康复景观高峰论坛暨学术研讨会论文集.北京:中国社会工作联合会,2015:261-268.
28 Arai H, Ouchi Y, Toba K, et al.Japan as the front-runner of superaged societies:perspectives from medicine and medical care inJapan. Geriatr Gerontol Int, 2015, 15(6):673-687.
29 Sackley CM, van den Berg ME, Lett K, et al. Effects of a physiotherapy and occupational therapy intervention on mobility and activity in care home residents:a cluster randomized controlled trial. BMJ, 2009, 339:b3123.
30 Krist L, Dimeo F, Keil T. Can progressive resistance training twice a week improve mobility, muscle strength, and quality of life in very elderly nursing-home residents with impaired mobility?A pilot study. Clin Interv Aging, 2013, 8:443-448.
31 De Coninck L, Bekkering GE, Bouckaert L, et al. Home-and community-based occupational therapy improves functioning in frail older people:a systematic review. J Am Geriatr Soc, 2017,65(8):1863-1869.
32 Forster A, Lambley R, Young JB. Is physical rehabilitation for older people in long-term care effective? Findings from a systematic review. Age Ageing, 2010, 39(2):169-175.
33汤军克,陈林利,陈建平.居家养老老年人日常生活活动能力及其影响因素.中国康复理论与实践,2012,18(4):372-375.
34丁琳,周婷.中国老年人康复护理和养老概况及分析.中国保健营养,2017, 27(23):187-188.
35姚瑞山,柯永红,袁晓晓,等.我国社区居家养老的现状及分析.全科护理,2012, 10(32):3055-3057.
36吕鹏飞,陈晓玲,周宏东,等.上海市医养结合养老模式卫生监督困境及对策.医学与社会,2016, 29(2):71-73.
37向钊娣.居家养老康复期老年人照护所需专职人员//国际老年健康论坛·泰山论文集.西安:西安市碑林区老年学学会,2016:357-358.
38唐路生.人口老龄化背景下的居家运动健康服务现状调查——以武汉市为例.武汉:华中师范大学,2016:33-36.
39张程远.我国持续照护型养老社区医疗康复区规划与设计研究.重庆:重庆大学,2018:26-27.
40杨晨.佛山市南海区“医养结合”康复养老模式研究.长沙:湖南大学,2018:24.
41郑洁皎.上海康复医疗服务体系中建立老年康复模式探索与研究//中国康复医学会第七次全国老年医学与康复学术大会论文集.哈尔滨:中国康复医学会老年健康专业委员会,2012:43-46.
42卓永岳.绿康康复养老模式的创新实践//2011年浙江省物理医学与康复学学术年会论文集.浙江:浙江省医师协会,2011:129-131.
43孙茜.中医“十三五”规划路:康复+养老.中国医院院长,2016(19):30-31.
44夏家红.武汉市“医养结合”模式评析.长江论坛,2014(6):41-43.
45王斌.公立医院为主体的机构养老探索上海君莲养老院及失智老人康复治疗中心方案介绍.时代建筑,2012(6):64-65.
46于涛,王昊,余海瑞,等.天津市部分养老院康复医疗现状及服务需求.中国康复医学杂志,2016, 31(1):77-79.
47许扬.医养结合养老机构发展困境及对策研究——以J县N养老康复中心为例.保定:河北大学,2017:11-13.
48管国富.常州社区老年人慢病康复养老服务基本情况及建议.江苏卫生事业管理,2011,22(4):101-103.
49罗治安,罗清平,罗云,等.养老机构老年人康复服务现状及对康复人才需求的调查研究.中国康复医学杂志,2018, 33(9):1081-1086.
50黄东,高阳.关于加快发展公办民营养老机构的思考——以宿迁市虹枫老年公寓为例.江苏经贸职业技术学院学报,2016(5):36-39.
51王声菲.康复花园设计策略研究——以杭州地区养老机构为例.杭州:浙江农林大学,2017:12-17.
52邵娜.医养结合模式下养老机构医疗康复空间的设计研究.丝路视野,2017(33):181.
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