China's Supply-side Reform in the Integrated Medical and Nursing Care Sector：an Analysis Using Michael Porter Diamond Model

doi:10.12114/j.issn.1007-9572.2018.34.008

Abstract

Abstract: With the acceleration of China's population aging，geriatric health issues are increasing.As the traditional elderly healthcare services are often unable to satisfy the healthcare needs of the elderly，it is necessary to promote the development of integrated medical and nursing care.However，there are many problems in the supply market of integrated medical and nursing care，such as lack of professionals，insufficient integration of social capital，inaccurate demand-supply matching，unbalanced allocation of resources and unfair competitive environment，and so on.So the supply-side reform in integrated medical and nursing care sector needs to be carried out prudently.We performed a scientific analysis of China's supply-side reform in the integrated medical and nursing care sector using Michael Porter diamond model，and put forward that，to implement the reform，it is necessary to improve the efficiency and service quality of integrated medical and nursing care sector by changing the role of government involvement in the sector，strengthening the training of professionals and applying advanced technologies.

Key words: Health care reform, Michael Porter diamond model, Pension, Health care and pension services, Supply-side reform

摘要： 随着我国人口老龄化程度的不断加深，老龄人口的健康问题与日俱增，传统的养老服务已经难以满足老年人需求，因此推行医养结合型养老服务成了社会的必然选择。但是，我国的医养结合型养老服务市场供给侧问题重重，专业型服务人员匮乏、社会资本整合不足、供给没有与需求精准匹配、资源配置不平衡、竞争环境不公平等，这些问题的出现均需要对医养结合型养老服务市场进行的供给侧改革重新审视。本文运用迈克尔-波特的钻石模型理论对医养结合型养老服务市场的供给侧改革进行科学分析，总结出我国医养结合型养老服务市场供给侧改革需要从政府角色转变、加强人才培养、利用高新科技等途径来提高医养结合效力，提升医养结合型养老服务市场整体服务水平。

关键词: 卫生保健改革, 钻石模型, 养老, 医养结合, 供给侧改革

WANG Zhaoqing,XING Yanan,QU Jing, et al. China's Supply-side Reform in the Integrated Medical and Nursing Care Sector：an Analysis Using Michael Porter Diamond Model　[J]. Chinese General Practice, 2018, 21(34): 4201-4205. DOI: 10.12114/j.issn.1007-9572.2018.34.008.
王召青,邢亚男,曲婧等. 基于钻石模型理论的医养结合型养老服务供给侧改革研究[J]. 中国全科医学, 2018, 21(34): 4201-4205. DOI: 10.12114/j.issn.1007-9572.2018.34.008.

References

［1］邓大松，李玉娇.医养结合养老模式：制度理性、供需困境与模式创新［J］.新疆师范大学学报（哲学社会科学版），2018，39（1）：107-114.DOI：10.14100/j.cnki.65-1039/g4.2018.01.011.
DENG D S，LI Y J.Integrating old age care with medical service：rational institution，imbalance between supply and demand and innovative solutions［J］.Journal of Xinjiang Normal University
（Edition of Philosophy and Social Sciences），2018，39（1）：107-114.DOI：10.14100/j.cnki.65-1039/g4.2018.01.011.
［2］许才明，荣超，谭建刚.失独家庭医养结合服务研究进展［J］.中国全科医学，2018，21（16）：1932-1937.DOI：10.3969/j.issn.1007-9572.2018.16.006.
XU C M，RONG C，TAN J G.Recent developments in the delivery of integrated medical and nursing care for elderly parents bereaved of their only child［J］.Chinese General Practice，2018，21（16）：1932-1937.DOI：10.3969/j.issn.1007-9572.2018.16.006.
［3］任继球.供给侧改革中的钢铁行业：发展成效与趋势展望［J］.宏观经济管理，2018，34（7）：23-30.DOI：10.19709/j.cnki.11-3199/f.2018.07.008.
REN J Q.Iron and steel industry in supply side reform：development effect and trend forecast［J］.Macroeconomic Management，2018，34（7）：23-30.DOI：10.19709/j.cnki.11-3199/f.2018.07.008.
［4］温海笑.欠发达地区农业供给侧结构性改革研究：以甘肃省为例［J］.甘肃农业，2017，32（16）：46-48.DOI：10.15979/j.cnki.cn62-1104/f.2017.16.011.
WEN H X.Research on structural reform of agricultural supply side in less developed areas：taking Gansu Province as an example［J］.Gansu Agriculture，2017，32（16）：46-48.DOI：10.15979/j.cnki.cn62-1104/f.2017.16.011.
［5］黄佳豪，孟昉.“医养结合”养老模式的必要性、困境与对策［J］.中国卫生政策研究，2014，7（6）：63-68.DOI：10.3969/j.issn.1674-2982.2014.06.011.
HUANG J H，MENG F.Integrating pension service with medical service for the elderly：necessity，dilemmas and solutions［J］.Chinese Journal of Health Policy，2014，7（6）：63-68.DOI：10.3969/j.issn.1674-2982.2014.06.011.
［6］廖清成，冯志峰.供给侧结构性改革的认识误区与改革重点［J］.求实，2016，58（4）：54-60.DOI：10.3969/j.issn.1007-8487.2016.04.010.
LIAO Q C，FENG Z F.Misunderstanding and structural reform of supply side structural reform［J］.Truth Seeking，2016，58（4）：54-60.DOI：10.3969/j.issn.1007-8487.2016.04.010.
［7］PORTER M E.国家竞争优势［M］.李明轩，邱如美，译.北京：华夏出版社，2002.
［8］沈婉婉，鲍勇.养老机构老人护理服务需求分析与政策建议［J］.上海交通大学学报（医学版），2015，35（4）：581-584.DOI：11.3969/j.issn.1674-8115.2015.04.023.
SHEN W W，BAO Y.Analysis of nursing service needs of old people in Shanghai nursing institutions for the aged and policy recommendations［J］.J Shanghai Jiaotong Univ（Med Sci），2015，35（4）：581-584.DOI：11.3969 /j.issn.1674-8115.2015.04.023.
［9］马鸿佳，董保宝.网络联系、吸收能力与市场战略效能关系研究［J］.科研管理，2011，32（10）：135-143.DOI：10.19571/j.cnki.1000-2995.2011.10.017.
MA H J，DONG B B.The relationships among network ties，absorptive capacity，and marketing strategy effectiveness［J］.Science Research Management，2011，32（10）：135-143.DOI：10.19571/j.cnki.1000-2995.2011.10.017.
［10］徐礼伯，钞小静，苏德金.新常态下的供给侧改革与中国产业结构升级：基于钻石理论的视角［J］.江海学刊，2016，59（4）：78-85.DOI：10.3969/j.issn.1000-856X.2016.04.013.
XU L B，CHAO X J，SU D J.The supply side reform under the new normal and the upgrading of China's industrial structure：based on the perspective of diamond theory［J］.Jianghai Academic Journal，2016，59（4）：78-85.DOI：10.3969/j.issn.1000-856X.2016.04.013.
［11］全国老龄办.三部门发布第四次中国城乡老年人生活状况抽样调查成果［EB/OL］.（2016-10-09）［2018-05-04］.http：//www.cncaprc.gov.cn/contents/2/177118.html.
［12］杨雨佳.供需视角下民非养老机构护理人员问题与对策研究［J］.中国管理信息化，2018，14（13）：191-193.DOI：10.3969/j.issn.1673-0194.2018.13.086.
YANG Y J.Study on problems and countermeasures of nursing staff in private pension institutions from the perspective of supply and demand［J］.China Management Informationization，2018，14（13）：191-193.DOI：10.3969/j.issn.1673-0194.2018.13.086.
［13］周佳，刘啸宇，李时华.“护工荒”：医养结合养老服务供给的一个主要瓶颈［J］.中国集体经济，2017，33（15）：123-124.DOI：10.3969/j.issn.1008-1283.2017.15.069.
ZHOU J，LIU X Y，LI S H."Labor shortage"：a major bottleneck in the supply of medical care and pension services［J］.China Collective Economy，2017，33（15）：123-124.DOI：10.3969/j.issn.1008-1283.2017.15.069.
［14］张伟涛.让养老产业健康持续发展［N］.中国社会报，2015-03-14（01）.
［15］王雯.推行“医养结合”养老服务模式的必要性、难点和对策［J］.中国老年学杂志，2016，36（10）：2538-2540.DOI：10.3969/j.issn.1005-9202.2016.10.108.
WANG W.The necessity，difficulties and countermeasures of implementing the mode of "medical service combination" for providing for the aged［J］.Chinese Journal of Gerontology，2016，36（10）：2538-2540.DOI：10.3969/j.issn.1005-9202.2016.10.108.
［16］朱浩.中国养老服务市场化改革三十年的回顾与反思［J］.中州学刊，2017，39（8）：66-72.DOI：10.3969/j.issn.1003-0751.2017.08.013.
ZHU H.Review and reflection on the thirty years' reform of China's pension service market［J］.Academic Journal of Zhongzhou，2017，39（8）：66-72.DOI：10.3969/j.issn.1003-0751.2017.08.013.
［17］张举国.“一核多元”：元治理视阈下农村养老服务供给侧结构性改革［J］.求实，2016，58（11）：80-88.DOI：10.3969/j.issn.1007-8487.2016.11.010.
ZHANG J G."One nuclear diversification"：structural reform of supply side of rural elderly services under the perspective of meta governance［J］.Truth Seeking，2016，58（11）：80-88.DOI：10.3969/j.issn.1007-8487.2016.11.010.
［18］廖芮，张开宁，王华平，等.我国健康老龄化背景下的医养结合：基本理念、服务模式与实践难题［J］.中国全科医学，2017，20（3）：270-277.DOI：10.3969/j.issn.1007-9572.2017.03.003.
LIAO R，ZHANG K N，WANG H P，et al.Combination between medical and elderly care institutions under the background of healthy aging in china：basic concepts，service modes and problems in practice［J］.Chinese General Practice，2017，20（3）：270-277.DOI：10.3969/j.issn.1007-9572.2017.03.003.
［19］巢莹莹，张迺英.健康中国战略下我国养老服务的困境与突破［J］.经济论坛，2017，31（6）：124-128，148，DOI：10.3969/j.issn.1003-3580.2017.06.028.
CHAO Y Y，ZHANG N Y.The predicament and breakthrough of China's pension services under the healthy China strategy［J］.Economic Forum，2017，31（6）：124-128，148.DOI：10.3969/j.issn.1003-3580.2017.06.028.
［20］刘诗洋，刘梦，桂玥，等.北京市医养结合养老机构的发展问题与对策［J］.中国全科医学，2016，19（33）：4034-4038.DOI：10.3969 /j.issn.1007-9572.2016.33.002.
LIU S Y，LIU M，GUI Y，et al.Development of old-age care institutions of medical-nursing combined in Beijing：problems and solutions［J］.Chinese General Practice，2016，19（33）：4034-4038.DOI：10.3969/j.issn.1007-9572.2016.33.002.
［21］张云.论医养结合养老服务中的政府责任［J］.人民论坛，2016，25（21）：78-79.DOI：10.16619/j.cnki.rmlt.2016.21.031.
ZHANG Y.On government responsibility in medical service and pension services［J］.People's Tribune，2016，25（21）：78-79.DOI：10.16619/j.cnki.rmlt.2016.21.031.
［22］刘淑娟.我国养老服务人才培养现状及对策研究［D］.秦皇岛：河北科技师范学院，2016.
［23］苏迪，韩红蕾.“互联网+”时代老年开放大学跨界融合研究［J］.成人教育，2017，37（9）：66-71.DOI：10.3969 /j.issn.1001-8794.2017.09.017.
SU D，HAN H L.Research on cross-border and fusion of open university for the elderly in the "internet+" era［J］.Adult Education，2017，37（9）：66-71.DOI：10.3969/j.issn.1001-8794.2017.09.017.

[1]	HUANG Jinling, ZENG Zhirong. The Logic and Trend of Urban Community Health Service Policies in China [J]. Chinese General Practice, 2023, 26(34): 4239-4245.
[2]	QIAO Hui, XIE Yongxin, XIAO Wenwen, GAO Baokai, CHEN Kexin. Progress and Effectiveness of the Health Status and Equity of Health Service Utilization of Rural Residents in Ningxia During 10 Years after the New Healthcare Reform [J]. Chinese General Practice, 2023, 26(22): 2726-2733.
[3]	CHEN Kexin, WANG Wenlong, HU Zhaoyan, GAO Baokai, QIAO Hui. Changes and Equity of Health Service Utilization in Middle-aged and Elderly People in Rural Mountainous Areas of Southern Ningxia during 10 Years after the New Healthcare Reform [J]. Chinese General Practice, 2023, 26(22): 2734-2739.
[4]	WANG Wenlong, GAO Baokai, HU Zhaoyan, CHEN Kexin, QIAO Hui. Equity and Influencing Factors of Health Service Utilization among Middle-aged and Elderly Adults with Disabilities in Rural Mountainous Areas of Southern Ningxia During 10 Years after the New Healthcare Reform [J]. Chinese General Practice, 2023, 26(22): 2740-2747.
[5]	GAO Baokai, HU Zhaoyan, WANG Wenlong, CHEN Kexin, QIAO Hui. Changes and Equity of Health Service Utilization in Married Women of Childbearing Age in Rural Mountainous Areas of Southern Ningxia after 10 Years of the New Healthcare Reform [J]. Chinese General Practice, 2023, 26(22): 2748-2755.
[6]	NI Jianxiao, GAO Guangying, ZHAO Ning, LI Jin, XU Jiajie, WU Nina, YANG Jia. Measurement of the Capitation-based Reimbursement Standard for Chronic Disease Management in Primary Care Clinics [J]. Chinese General Practice, 2023, 26(19): 2355-2360.
[7]	Dongfeng TANG, Sioutang HUANG, Xuan ZHOU, Herngchia CHIU. Paying for Quality: Experience from the UK and Inspiration for China's Healthcare Payment System [J]. Chinese General Practice, 2022, 25(28): 3459-3465.
[8]	Tao LUO, Yue ZHAO, Lanqiu LIU. Development of the Hospice Care System in China in the Promotion of Healthy Ageing: Status and Recommendations for Problems [J]. Chinese General Practice, 2022, 25(19): 2315-2319.
[9]	Yue ZHAO, Lanqiu LIU. The Model of Community Home-based Hospice Care Delivery in the United Kingdom and the United States and Its Enlightenment to China [J]. Chinese General Practice, 2022, 25(19): 2330-2335.
[10]	ZHANG Yujie, YIN Wenqiang, YAN Yu, SUN Yan, LI Cuiyu, ZHANG Tiantian, MENG Cuixiang, HU Jinwei, CHEN Zhongming. Chinese Elderly Residents' Willingness to Use Integrated Medical and Nursing Care：a Meta-analysis [J]. Chinese General Practice, 2022, 25(10): 1269-1274.
[11]	ZHAO Runze, YU Haiyang, HAN Xu. Cuba's Community Health Services：Introduction and Implications to China [J]. Chinese General Practice, 2022, 25(04): 387-392.
[12]	WANG Huijuan, LIU Xiaoyun. Changes in Beijing Residents' Primary Care Utilization during the New Round of Healthcare Reform：a Study Based on 2013 and 2018 Waves of the National Health Service Survey [J]. Chinese General Practice, 2022, 25(01): 50-54.
[13]	LIN Chunmei，QIN Jiangmei，ZHANG Lifang，ZHANG Yanchun，MENG Yeqing，WANG Xin. Construction of Community Hospitals in China as of 2020：an Analysis Using Tracking and Monitoring Data　 [J]. Chinese General Practice, 2021, 24(31): 3909-3913.
[14]	WANG Binding，LIU Gang，ZHENG Xinlie，WANG Hang，ZHANG Baolu. Unmet Needs of Activities of Daily Living and Influencing Factors in the Elderly：a Survey from Medical and Nursing Care Institutions　 [J]. Chinese General Practice, 2021, 24(19): 2465-2471.
[15]	DAI Wenyun，HU Ling. Exploration and Practice of Primary Health Care during the Construction of County-level Medical Alliance　 [J]. Chinese General Practice, 2021, 24(1): 23-29.