Medical empowerment community hospitals for the aged are ＂embedded＂ in public nursing homes, so that the elderly can rely on ＂medicine＂

CCTV News:In 2022, the National Health and Wellness Commission, as a pilot area of geriatric medical care services in 15 provinces including Beijing and Jiangsu, innovated and diversified geriatric medical care services and increased the supply of multi-level geriatric medical care services. In January, 2023, the first new type of nursing home with combination of medical care and nursing was officially put into operation in Jiangsu Province, which was embedded in a public nursing home in a community health service center. How is its operation in the past year? The reporter conducted a field interview.

Starting this year, Xu Guangqing, director of the Outang Community Service Center in Huishan District, Wuxi City, has another identity as the dean of the Outang Nursing Home.

Xu Guangqing, Director of Outang Community Health Service Center, Huishan District, Wuxi City, Dean of Outang Nursing Home:The biggest feature of our nursing home is medical empowerment for the elderly. In the original community health service center, we rely on more than 120 medical and nursing staff to empower the nursing home with basic medical care, rehabilitation and nursing. In space, the nursing home is close to the community health service center.

At 8 o’clock in the morning, the activity center on the third floor of Outang Nursing Home began to be lively. Many elderly people improved their physical function through exercises, games and other activities.

Zhou Yuhong, Therapist, Outang Nursing Home, Huishan District, Wuxi:Aunt Yu, who lives in bed 11 on the third floor, had great defects in language, cognition and physical coordination when she first came here. After three or four months of rehabilitation training, the limb function recovered obviously, and they were able to eat independently, and their cognitive function improved, and they were able to interact, communicate and play with other elderly people.

Aunt Yang’s parents are both in their eighties. The two old people originally lived separately. My father lived in a nursing home and my mother lived at home for the elderly. Aunt Yang herself is 64 years old, and it is very hard to take care of the elderly at both ends every day. Two months ago, Aunt Yang’s parents finally got together again in the Outang Nursing Home, and after exercise and rehabilitation, the old man’s physical function was greatly improved, and he often played chess with other old people, making his life more quality in his later years.

Ms. Yang, a resident of Huishan District, Wuxi City:When my dad came, he just slept in the bed and didn’t move. After coming, the doctors, nurses and nurses are all fine. They feel that they were not happy when they first came, but they were very happy when they came later. The rehabilitation teacher has been training him, interacting with him, playing games for him, and sometimes he will come down. So, we are also very happy, really happy.

At present, there are 119 beds in 3 nursing wards of Outang Nursing Home, which mainly treat the elderly with mobility difficulties and difficulties in self-care. Nursing homes share medical teams and equipment with community health service centers, so that the elderly can get integrated medical care, rehabilitation promotion, hospice care and other services.

Huishan District, Wuxi CityXu Guangqing, Director of Outang Community Health Service Center and Dean of Outang Nursing Home:At the same time, we rely on the medical community of Huishan District People’s Hospital. They also set up seven or eight specialist clinics here. In case of urgent trouble, we can make transshipment at 120. Secondly, it is convenient for them (doctors from Huishan District People’s Hospital) to come over, as long as it takes ten minutes, which makes the families of the elderly feel very at ease and assured.

Revitalize primary medical resources and support old and high-quality nursing resources

In Huishan District, Wuxi City, many elderly people need high-quality nursing resources, while there are 8 hospitals within 5 kilometers of Outang Community Health Service Center, and some primary medical and health institutions have idle beds and underutilized facilities and equipment. In this case, community hospitals are "embedded" in public nursing homes, which can be said to kill two birds with one stone.

Huishan District, Wuxi CityXu Guangqing, Director of Outang Community Health Service Center and Dean of Outang Nursing Home:Many resources of our original community health service center were idle. For example, the utilization rate of beds in our country is about 30%, and there are many medical staff who are usually responsible for some public health work, but there are still some time when they are free. The center is still a big pot model in terms of performance rewards. In fact, there is little difference between doing more and doing less. Therefore, many employees have no enthusiasm for work in this respect and are unwilling to pay more.

Although the Outang Community Health Service Center is small, it has complete departments and hardware, which can meet the diagnosis and treatment of common diseases and frequently-occurring diseases.

How can we use the idle equipment and beds in community health service centers? Increase income and motivate employees? After repeated investigations, many departments in Wuxi took the lead in issuing policies in Jiangsu Province to encourage qualified community health service centers (township hospitals) to set up new policies for nursing homes without changing their functions or increasing their establishment. Using the idle resources of community health service center, the breakthrough of public nursing home was realized. This new model runs according to the settlement mode of one legal person, one team, two medical institutions and two medical insurance.

Sheng Mingmin, Department of Primary Health and Health, Huishan District Health and Health Committee, Wuxi City:Considering that we should use this idle resource, we should also keep medical staff busy. The government fully considered embedding a nursing home in the community center. One can solve the problem of providing for the elderly in our jurisdiction, and at the same time improve the enthusiasm of medical staff.

The elderly can enjoy the basic medical insurance policy of settlement by bed day.

Setting up a public nursing home in the community health service center is a brand-new way for the community health service center, and it is even more good news for the surrounding elderly people. At present, the Outang Nursing Home in Huishan District, Wuxi City has officially opened, and has treated more than 350 elderly people and patients.

After the community health service center has added the medical care function, the elderly who live in the community can enjoy the basic medical insurance policy of bed settlement, and the elderly who meet the long-term care insurance can also enjoy 30-mdash every day; Subsidies for long-term care insurance in 50 yuan.

Huishan District, Wuxi CityXu Guangqing, Director of Outang Community Health Service Center and Dean of Outang Nursing Home:Wuxi’s policy is still relatively good. The medical insurance policy of nursing homes is to settle accounts by bed day. Every day, the government can have 100 yuan medical insurance support and 100% bed day settlement support. If you are a local patient, you can also enjoy reimbursement and subsidy policies such as long-term care insurance, and your own expenses will be less.

The innovation of the model has revived the health service center of Outang, which has been well received by patients and their families since the opening of the nursing home. At the same time, the business income of Outang Community Health Service Center has also been greatly improved, and the medical staff have also experienced the feeling of being busy and happy.

Huishan District, Wuxi CityXue Tingxian, Deputy Director of Nursing Department of Outang Community Health Service Center:In the past, the number of patients was almost maintained at around 20. Now, I am basically in the first and second nursing districts. Basically, the number of patients in the first nursing district is in the thirties, and the number of patients in the second nursing district is in the twenties, which is equivalent to the number of patients in a ward who have reached the previous center, and the number of people in the workload is doubled.

Xue Tingxian has just returned from studying in Zhongshan Geriatric Rehabilitation Hospital. For her, every day is a basic moment.

Huishan District, Wuxi CityXue Tingxian, Deputy Director of Nursing Department of Outang Community Health Service Center:Here (the patient’s condition) is basically severe, and the work is continuous, basically non-stop. The technical requirements are also relatively high. Through our going out to study and further study, our technical level can be greatly improved in all aspects.

Huishan District, Wuxi CityXu Guangqing, Director of Outang Community Health Service Center and Dean of Outang Nursing Home:Our assessment by the Health and Health Commission is totally different from the previous one, which may increase our performance by 5% to 10%.

After one year’s operation, the Outang Nursing Home has achieved a win-win effect, the elderly have been better cared for, the enthusiasm of medical staff has increased, and the business income of the community health service center has been greatly improved. Wuxi City said that on the basis of the pilot project of Outang Nursing Home, it will start the pilot project of public nursing homes in other areas one after another, and constantly explore more beneficial and effective experiences and measures for the combination of medical care and nursing.