Abstract:

Establishing and improving the hospice care system is an integrant part of healthy ageing. Currently, hospice care has been a part of the national healthcare services, and models of provision of hospice care using multi-agent approaches have been formed in China. Furthermore, the inpatient-outpatient-home-based hospice care model has begun to take shape. And some regions have also explored the guidance center-demonstration base-professional institutions-based system for promoting hospice care. However, many problems have been revealed during the development of the hospice care system, such as low coverage of hospice care, uneven distribution of hospice care resources, imperfect mechanisms for eligibility approval, performance assessment and ineligibility exit targeting hospice care provision institutions, and the absence of an integrated hospice care model. In view of this, we put forward the following recommendations: legally defining hospice care belonging to essential healthcare services in essence, improving the inpatient-outpatient-home-based hospice care model, building an integrated hospice care system focusing on home-based hospice care in communities, and establishing a national center-regional center-professional institutions-based hospice care promotion system.

Key words: Hospice and palliative care nursing, Health care reform, Healthy aging, National health system, Basic medical and health services

摘要：

建立健全安宁疗护服务体系是健康老龄化的应有之义。当前，我国安宁疗护服务已纳入国家医疗卫生体系，形成了多主体安宁疗护服务供给局面，"住院-门诊-居家"的多元安宁疗护服务模式初具雏形，部分地区还探索出安宁疗护"指导中心-示范基地-专业机构"的推进体系。但我国的安宁疗护服务体系构建仍存在覆盖面窄且分布不均，安宁疗护服务提供机构准入、评价、退出机制尚待健全，整合性安宁疗护服务模式尚未建立等诸多问题。应明确安宁疗护"基本医疗卫生服务"的法律性质，健全"住院-门诊-居家"安宁疗护服务模式，构建以基层社区居家安宁疗护服务为重点的整合型安宁疗护服务体系，建立安宁疗护"国家中心-区域中心-专门机构"的推进体系。

关键词: 临终关怀和姑息治疗护理, 卫生保健改革, 健康老龄化, 国家医疗卫生体系, 基本医疗卫生服务