基于社会网络分析的老年人医养结合服务激励机制研究

Combination of medical care and elderly care directed by healthy aging, are the key measures to aging degree deepened and supply-demand contradictions of elderly resources. The services refer to the two administrative departments of health and civil affairs, and their policies systems. There are problems of policies and regulations conflict, the fuzzy location, profit difficulty and hard to sustainable development. However, incentive mechanisms are the core of encourage the subjects to participated the services and the development and performance of the services..The research aim at the four models of combination of medical and elderly care, bring in social network theory, design incentive mechanisms from two aspects: institutions and individuals. By constructing the service social network model under the different modes of combining services, analyze the dynamic relation and operation rules of the network subjects, realize supply-demand situation and willingness of the services. Then, in the aspect of institution, establish the Benefit Share Mechanisms based the relation of efficiency and risk in the social network. In the aspect of individual, identify the key point of incentives; design the motivation mechanisms and schemes. Empirical study will conducted at last. The research provide the basis of policymaking and improvement of the combination services, the theoretical support and path selection of the development of the medical and elderly services integration.

以健康老龄化为导向的医养结合服务是中国应对老龄化程度快速加深、解决老年医养资源供需矛盾的关键。当前医养结合涉及卫生与民政两大管理部门及其政策体系，存在政策法规矛盾、定位模糊、盈利困难、难以可持续发展等问题。而激励机制则是鼓励各方主体参与医养服务且攸关服务开展和取得实效的核心。.本研究针对我国医养结合服务实施的四种主要模式，引入社会关系网络理论，从机构和个人两个层面设计激励机制。通过构建不同模式下医养结合服务社会网络模型，分析医疗方、养老方、老年人群等网络主体的动态关系和运行规律，以关系变量数据解析医养服务的供需状况及各方参与意愿。在机构层面，建立基于医养社会网络的效益关系、风险关系的效益分享机制；在个人层面，以社会网络分析识别激励关键因素，设计医养服务人员的激励机制及行动方案，并进行实证研究。从而为制定和完善医养结合激励政策提供依据，为促进老年人医养服务融合发展提供理论支撑和路径选择。

人口老龄化是贯穿我国21世纪的基本国情。广大老年人口的养老、医疗、照料等方面的服务供给，是当前我国面临的重要问题。国家提出健全以居家为基础、社区为依托、机构为补充、医养相结合的养老服务体系的基本政策，是我国应对日益严峻的老龄化问题的重要举措。本研究基于社会网络分析对老年人医养结合服务激励机制进行分析，结合当前政策现状，提出激励策略以推动各类服务主体深入开展医养结合项目，更好的满足老年人健康养老服务需求。.研究构建了基于社会网络分析和激励理论的理论框架，系统综述可用于医养结合相关服务提供方的激励理论、策略，明确激励偏好和影响；调查老年人对医养结合服务的需要、需求偏好及利用情况，了解不同类型居家老人的服务需求；着重了解社区机构对医养结合项目的开展意愿与可行性，分析各类医养结合服务供需双方的差异，探讨如何激励各服务主体提供相关服务项目；从社会层面、机构层面和个人层面，提出医养结合服务的激励机制和方案，经过验证提出完善的服务激励建议。.激励机制是关系到医养结合项目开展是否有效和可持续的关键，通过社会、机构、个人三个层面的激励，调动医养服务供给方的积极性和主动性，充分整合和利用有限的卫生服务资源改善老年人健康状况，实现老有所养、老有所医，推动国家健康老年化的实现。