Abstract: A hospital-centered health care system does not serve the needs of aging population，and fragile and old patients need home-centered medical care.There are very limited number of home care programs in China，and these programs provide skilled nursing，primary care，and therapy services at home，while nurses are the main staff.Four different healthcare modes are provided in home care services，including home bed services represented by community health service centers，door-to-door services represented by public hospitals in transition period，integrated services represented by hospital groups and simple home-based medical services represented by private medical services.These medical institutions provide home-based medical services with different purposes and income patterns，but they all meet the needs of the elderly and the weak.This paper described the current service models of home-based health care in China and the challenges they face in their development process.

Key words: Home care, Door-to-door medical care, Home care services, Aging, Community health services

摘要： 目前，以医院为中心的医疗体系已经不适应老龄化社会的需要，老弱患者更需要居家医疗。中国的居家医疗项目极少，服务内容以护理、全科、康复服务为主，服务人员主要是护士。目前服务模式共有4种，包括以社区卫生服务中心为代表的家庭病床服务、以转型期公立医院为代表的上门服务、以医院集团为代表的整合型服务以及以民营医疗为代表的单纯居家医疗服务。这些医疗机构提供居家医疗服务的初衷有所差异，收入模式也不相同，但均在满足老弱患者的需要。本文描述目前中国居家医疗的服务模式以及发展过程中面临的挑战。

关键词: 居家医疗, 上门医疗, 家庭医疗保健服务, 老龄化, 社区卫生服务