With the aggravation of population aging, the medical and care needs of the elderly have increased significantly. Nowadays the integrated elderly care and medical services have been greatly promoted and various services modes have been developed in different regions. In order to promote the healthy development of integrated elderly care and medical services in China, we summarized the practical experience of integrated elderly care and medical services implemented in various parts of China, including six typical service modes such as elderly care in medical services, medical care in elderly care, cooperation between medical services and elderly care, community radiation, family doctor embedded and “Internet+”. Moreover, we compared their providers, service methods, construction specifications, service standards, regulatory agencies and payment methods. Finally, we analyzed the problems and their causes, and proposed corresponding improvements for outstanding problems in the practice of integrated elderly care and medical services in China.
Objective To analyze the advancement and trends of English literature on elderly integrated care, and provide a reference for related research and practice in China. Methods Web of Science database was searched for English literature on elderly integrated care published between 1977 and 2000, and then CiteSpace software was applied to analyze and graphically present the articles to understand the chronological development, publishing institutions, research hotspots, key articles and so on. Results A total of 1177 English research papers on elderly integrated care were included. The yearly quantity of articles increased significantly since 2016. More than 100 articles had origin in the Unite State of America, the Netherland, the United Kingdom, and Canada, respectively; the organizations of those researches were mainly single programs, and the research fields were relatively scattered. The high-frequency keywords of these articles were health care, quality of life, primary care, home care, community, chronic disease, long term care, mental health, etc, and the burst terms were long term care, case management, quality of life, community, rehabilitation, telehealth, all inclusive care, etc. According to the centrality of co-citation clustering, the top one article was World Report on Ageing and Health published by the World Health Organization. Conclusions Elderly integrated care has been paid increasing international attention. In recent years, integrated care, transitional care, case management and telecare have become research hotspots. With the key policies of people-centred and integrated health services, primary care, and community-level interventions, typical countries have developed basic models of elderly integrated care. The above theories and experiences can provide references for the practice of elderly integrated care in China.
Aiming at the shortcomings in the theory and practice of integrated elderly care and medical services in China, using the methods of literature analysis and comparative analysis, we summarize four typical models of integrated elderly care and medical services, namely, the American commercial pension model, the British national tax financing system pension model, the Japanese national security transformation, and the German long-term care insurance system, and compare the four models systematically from the aspects of system overview, service principle, operation mode, financing supervision, etc. The enlightenment for the policy and practice development of integrated elderly care and medical services in China is obtained: firstly, the service concept should be innovated; secondly, it is important to improve the relevant legal protection and supporting measures; thirdly, the refinement of the integrated elderly care and medical service projects are supposed to be promoted; fourthly, a multi-party linkage mechanism ought to be establishd; and fifthly, community endowment model should be advocated.
This paper systematically compares the common integrated elderly care and medical services models and related elements in China, analyzes the six major elements of system dynamics order flow, capital flow, equipment flow, personnel flow, information flow and material flow under the health care integration service model, compares the current situation of the application of system dynamics in the operation mechanism of the integrated elderly care and medical services model, supporting policies, cooperation and collaboration model, effect evaluation and industrial prediction simulation of key elements, summarizes the shortcomings of the existing application research and proposes research outlook, and provides a theoretical basis for the optimization research of the integrated elderly care and medical services model.
Objective To explore the matching relationship between the supply and demand of different types of integrated elderly care and medical service for the elderly population in the region, and achieve the simulation purpose of coordinated allocation and balanced development of supply and demand of integrated elderly care and medical service. Methods Combining literature, interviews, and expert consultation to sort out the main factors and system element relationships between the supply and demand of integrated elderly care and medical service in the region, the Vensim software was used to clarify the relationships and operation mechanisms between the subsystems of supply and demand of integrated elderly care and medical service. The data of the construction base for the integrated elderly care and medical service project in Suzhou city, Jiangsu province from January 1, 2010 to December 31, 2022 were selected. Results Combined with the accessibility and completeness of data, the main variables and indicators of the five subsystems were screened, and the causality diagram and flow diagram of the system dynamics were drawn to clarify the main variables and flow direction of the subsystems, and the constructed model was more stable in simulation operation. The simulation model results showed that the supply-demand ratio of home-based elderly care and community elderly care decreased relatively before 2012, and the institutional elderly care model gradually emerged and developed from 2013 to 2018. From 2019 to 2022, the supply-demand ratio of medical care with elderly care and elderly care with medical care decreased. Conclusions Based on the theoretical foundation of system dynamics, the supply and demand the integrated elderly care and medical service in the region are regarded as a complex system. Through the analysis of the system elements among the subsystems and the sorting out of the mechanisms, it can provide certain theoretical support for constructing and improving the system dynamics model for matching the supply and demand of integrated elderly care and medical service in the region.