Introduction: The People’s Government of Guangdong Province recently published the Opinions on Implementation of Work to Promote Integration of Medical and Health Services and Elderly Care Services (“the Opinions”), encouraging social forces to set up establishments that combine both medical and elderly care services. All elderly care establishments must provide medical and health services, and implement the policy of expanding the coverage of basic medical securities to cover some medical and rehabilitation programs such as comprehensive limb training for hemiplegic patients, recognition and cognition function rehabilitation training, assessment of daily living abilities, etc.

Several indicators specified in the Opinions

By 2017, over 60% of the elderly people aged above 65 years will be covered by the contract service and health management service offered by family doctors; over 80% of the medical institutions will open a green channel for offering conveniences to the elderly people in registration and other hospital service procedures; and, over 50% of the elderly care establishments can provide medical and health services of various forms for the in-house elderly people, so as to achieve obviously higher accessibility of the elderly health and nursing services.

By 2020, through orderly sharing of the medical, health and elderly care service resources across the province, a service system of a moderate scale with complete functions for combining medical and elderly care services for both urban and rural areas will be established, fundamentally catering to the elderly people’s needs for elderly care services; over 80% of the elderly people aged above 65 years will be covered by the contract service and health management service offered by family doctors; the medical institutions of the basic level will have an obviously improved capability to provide door-to-door service for the elderly at home; all medical institutions will open a green channel for the convenience of the elderly people in registration and medical service; and, all elderly care establishments can provide medical and health services of various forms for the in-house elderly people.

Exploring the possibility of establishing a mechanism for moving the nursing service to elderly care establishments

The Opinions expressly encourages integration of medical institutions and elderly care services for development, and particularly encourages setup of a geriatrics department in general hospitals of level 2 or above. The preferential policies for the elderly’s medical services should be put into practice, and convenient services should be offered to the elderly, particularly those elderly people who are at older ages, in critical diseases or in full or partial disability, during registration, diagnosis, referral, medicine pick-up at the pharmacy, payment at the cashier and other general medical treatment procedures. At the same time, the Opinions also encourages actively exploring of the possibility of establishing a mechanism for moving the nursing service to elderly care establishments, and encourages those elderly care establishments meeting criteria to take care of the fully-disabled or partly-disabled elderly people in the medical institutions who need long-term care, so as to address the “bed occupying” issue facing by the medical institutions. In order to encourage social forces to set up establishments that combine both medical and elderly care services, the Opinions clearly state that social forces will be supported when they set up such establishments as the geriatrics hospital, senior rehabilitation hospital, nourishing home for the elderly and senior health management center that combine both medical and elderly care services through the ways of franchised operations and various public-private partnerships, and relevant approval procedures will also be further simplified.

Door-to-door services to be provided for disabled elderly

Q: In many Chinese families, the elderly people are still cared at home. What should we do if the elderly at home need medical services?

The Opinions put forward that medical and care service items for the elderly people at home will be standardized and those medical service items that meet the regulations will be covered by medical insurance; and, those low-income elderly people who are at an older age, fully disabled or partly disabled, or have difficulty in moving or other difficulties in a special family-planning family, will be offered door-to-door medical service or care service at home with the cost covered by government purchasing or subsidizing. The Opinions also clearly state that more insurance products for elderly care including long-term commercial care insurance should be further developed and the senior people should be encouraged to subscribe these long-term care insurance products. It is encouraged to explore the possibility of set up a long-term care insurance system and a diversified insurance fund raising model where conditions permit to protect the elderly’s need for long-term care services. The policy of expanding the coverage of basic medical securities to cover some medical and rehabilitation programs such as comprehensive limb training for hemiplegic patients, recognition and cognition function rehabilitation training, assessment of daily living abilities, etc., should be put into practice.