China News Service, Ningbo, September 17 (Zhang Yuhuan) "Aunt, your complexion looks good today. Can you see my fingers? How many fingers are these?" Recently, in Yangming Street, Yuyao City, Ningbo, Zhejiang, Chen Qi, a doctor from the Community Health Service Center, came to conduct disability level assessment for the elderly. Detailed consultation, item-by-item physical check, patient emotional comfort, and a set of professional assessment processes are completed in an orderly manner, accurately determining the care needs of the elderly.
The scene of door-to-door assessment and considerate consultation is a daily portrayal of the promotion of refined elderly care services in Yuyao, Zhejiang. As a pilot area for the integrated reform of "medical care and care assistance" for disabled and dementia elderly people in Zhejiang Province, the local area has revitalized primary medical resources, allowing medical staff to cross-border and become disability assessors, opening up a key link in the accurate matching of elderly care services, and using subtle reform measures to weave a dense medical care and care security network for urban and rural elderly groups.
Cross-border medical and nursing work to maintain the first barrier to precision elderly care
The ability assessment of the elderly is the core basis for accurately implementing long-term care insurance benefits, matching elderly care resources, and customizing home care plans. It is the "first gate" for refined elderly care services.
As an emerging profession, disability assessors need to master comprehensive knowledge of geriatric medicine, rehabilitation care, policies and regulations, etc., and use more than 20 indicators from the four dimensions of daily living ability, mental state, perception and communication, and social participation to classify the elderly into four ability levels: intact, mild, moderate, and severe. The assessment results are directly related to the elderly people's personal pension rights.
In response to past pain points such as multiple applications for disability assessment, repeated assessments, and tedious errands for the public, Yuyao has implemented provincial reform arrangements, and multiple departments have jointly launched a special plan to promote the "multiple assessments in one" reform for people with disabilities and dementia, and promote the standardization and convenience upgrade of assessment services. The local government gives full play to the advantages of the primary health care system and recruits the best medical personnel to form a professional evaluation team, turning frontline doctors into exclusive evaluators and working on the frontline of urban and rural elderly care services.
Uncle Hua from Huajia Village, Huangjiabu Town, was bedridden for a long time due to a stroke and was unable to take care of himself. Xie Qiquan, an assessor from the local health center, took the initiative to come to the house to check the elderly's ability to take care of himself, such as eating, turning over, washing, and going to the toilet. He objectively determined the level of disability and simultaneously investigated hidden dangers in home care. This provided an authoritative basis for family members to apply for long-term care insurance and formulate scientific care plans, allowing precise elderly care services to be delivered directly to the doorstep.
At present, Yuyao has established a full-time disability assessment team of 95 people, including 34 assessment experts and 61 full-time assessors, covering multiple core disciplines such as orthopedics, neurology, geriatrics, and traditional Chinese medicine, achieving full coverage of street services in 21 towns and villages in the city. The professional and diversified talent allocation can accurately adapt to the assessment needs of the elderly with different physical conditions and different types of diseases.
Global pilot empowerment to build a new pattern of medical and health care integration
In April this year, Yuyao was approved as a pilot project for the integrated reform of "medical care and nursing assistance" for disabled and dementia elderly people in Zhejiang Province. Comparing the provincial and municipal reform task lists, the local government focuses on key aspects such as base calculation, institutional empowerment, and resource sinking to comprehensively solve problems such as resource dispersion and mismatch of supply and demand.
Accurate service starts with accurate planning. Yuyao innovatively established a dynamic screening mechanism of "data aggregation + manual verification". Through big data screening to capture information on elderly-related diseases, superimposed on public security data screening and deduplication, more than 2,600 elderly people suspected of being disabled and demented were initially screened out, laying a solid data foundation for targeted policy implementation and precise services.
In terms of improving the quality of institutional services, the local government has promoted public medical institutions to be included in the designated long-term care insurance, and introduced special support measures to break down barriers to industry entry. This year, the city plans to add 7 new designated public medical institutions for parent care insurance.
In order to promote the deep integration of medical resources into the elderly care scene, Yuyao has also achieved full coverage of medical and nursing cooperation with local elderly care institutions, clarified regular services such as patrol consultations, rehabilitation care, two-way referrals, and emergency green channels, and implemented the "medical care in nursing" service model. The local government is simultaneously promoting the construction of "embedded health service rooms + family doctor studios" in elderly care institutions. It plans to complete the standardized transformation of 13 institutions by the end of October and create multiple benchmark service points so that the elderly in the institutions can enjoy professional medical services without leaving the hospital.
Detailed measures to improve people's livelihood and create a dense urban and rural elderly care and medical security network
Based on the differentiated needs of urban and rural elderly care medical services, Yuyao has made up for the shortcomings of grassroots health care, enriched service scenarios, and made efforts from multiple dimensions such as hospice care, medical care pilots, home services, and mountainous area assistance to build a multi-level, full-coverage elderly care service system.
In the field of hospice care services, Yuyao is preparing to build a municipal-level hospice care guidance center to coordinate the standardized development of all-area services. The center is expected to be officially put into operation by the end of September. At present, six local township health centers have completed the deployment of hospice beds. Through special talent training, all 21 towns and streets in Yuyao city are qualified for home hospice care services, comprehensively consolidating the grassroots terminal health care service capabilities.
At the same time, the local government actively explores the new model of "medical-run nursing care", promotes the pilot of "increasing medical care in medical care" in public medical institutions, and jointly promotes the construction of the Simen Town Community Health Service Center elderly care project with multiple departments, opening up a new path for the extension of medical resources to elderly care services.
From a door-to-door assessment to the establishment of a comprehensive system, using "small incisions" to promote "greater people's livelihood", Yuyao is committed to allowing every disabled elderly person to enjoy a dignified, comfortable and quality life in their later years.
