摘要
背景人口老龄化背景下,居家医疗是国外为老弱失能人群提供可及性医疗服务的有效手段,我国也在积极推进居家医疗服务,但我国的居家医疗尚处于起步阶段,许多问题有待研究。目的从居家医疗实践者的角度深入了解我国居家医疗发展的内外部挑战,为实践健康中国战略和积极应对老龄化提供新思路。方法采用质性研究中的现象学研究方法,于2018-06-18至2018-07-07,从参加过中国第三期居家医疗培训会的人员中,通过目的抽样抽取14名开展过居家医疗的医务人员和对居家医疗感兴趣的科研人员,进行半结构式深度电话访谈,运用Colaizzi七步分析法整理访谈资料,凝练主题。结果根据主题重要程度和重复频率提炼出2个主题:(1)居家医疗发展存在的问题,包括居家医疗质量和安全风险高、居家医疗供方服务能力不足、现代居家医疗科技设备欠缺;(2)居家医疗面临的外部挑战,包括法律法规支持力度不足、居家医疗经济保障少和受到不利的社会环境影响。结论发展我国的居家医疗尚面临诸多内外部挑战。一方面,政府需要增加对居家医疗的经济支持和法律保障;另一方面,居家医疗服务人员需要提升自身服务能力,提高居家医疗服务质量。
Background Home-based medical care is a good way to provide older,weak and disability populations with accessible health care in an aging society at abroad.China is promoting the emerging home-based medical care,but many problems during the process need to be solved.Objective This study was to intensively explore the challenges of home-based clinical care in progressing in China from the perspectives of home care providers,offering new ideas for achieving the goals of building a healthy China and for proactively coping with the aging society.Methods A qualitative study was carried out from June 18,2018 to July 7,2018 with a phenomenology approach.By use of purposive sampling,14 medical workers with an experience of delivering home care and researchers with an interest in home care were selected from those who participated in the Third International Training on Home Care,and received an in-depth semi-structured telephone interview.The Colaizzi’s method was used to analyze the interview data and summarize themes.Results Two major recurring themes of foremost importance were summarized as follows:(1)Problems in the development of home-based medical care:high risks of quality and safety,and insufficient capabilities of providers together with inadequate technology equipments to offer services to meet people’s needs of home-based care.(2)External challenges:insufficient supports from laws and statutes,low economic security,and negative impact of the social environment.Conclusion China is facing many internal and external challenges in the development of homebased medical care.To address these challenges,governmental economic and law supports for home-based medical care should be increased,and home-based medical care providers should enhance their professional capabilities to advance the quality of homebased medical care.
作者
陈涛
姚能亮
苏明珠
农圣
柏萌
马梓媛
CHEN Tao;YAO Nengliang;SU Mingzhu;NONG Sheng;BAI Meng;MA Ziyuan(School of Health Care Management/NHC Key Laboratory of Health Economics and Policy Research,Shandong University,Jinan 250012,China;Youjiang Medical University for Nationalities,Baise 533000,China)
出处
《中国全科医学》
CAS
北大核心
2020年第12期1459-1465,共7页
Chinese General Practice
关键词
家庭医疗保健服务
居家医疗
上门医疗
老年人
定性研究
Home care services
Home-based medical care
Door-to-door care
Aged
Qualitative research
作者简介
通信作者:姚能亮,教授,博士生导师,E-mail:ayao@sdu.edu.cn。
