关键词: 老年人, 医养结合, 养老机构, 广西

Abstract: Objective　To summarize the typical development model of institutions combining old-age care and medical care in Guangxi；to analyze the main problems currently affecting this development；and to propose targeted policy recommendations.Methods　Using a typical survey method，Guangxi Nanning，Guilin，Beihai，and Liuzhou were selected as the project research areas.In each area，a representative old-age care institution between July and September 2015 was selected.Comprehensive surveys and in-depth interviews with staff were used.In the four old-age care institutions，20%–40% of the staff were randomly sampled to conduct a questionnaire survey，and 1 or 2 of the persons in charge in the investigated old-age care institutions were interviewed in depth.The investigation assessed a combination of medical care and old-age care services；the nature，scale，sources of funds，and fees in old-age care institutions，as well as the educational levels of the staff in those institutions.Results　There were three main modes of combination of medical-care and old-age care services in Guangxi：establishment of medical institutions in old-age care institutions；establishment of nursing homes in medical institutions；and establishment of institutions providing collaborative old-age care and medical care services.There were two types of institutions：public and private.The number of beds has increased each year，but the total number has been insufficient.The main source of funding for infrastructure construction of elderly nursing homes was established by states，but the institutions are run privately，independently of government investment.Each bed in an old-age care institution costs RMB 400–1 200 per month；the nursing fees for first-，second- and third-tier care providers are RMB 400–1 400 per month；and the living expenses are RMB 400–600 per month.In addition，the rehabilitation physiotherapy services in the institutions combining old-age care and medical care，as well as other service costs，make the overall service charges of old-age care combined medical care institutions very high，such that the income of the elderly is insufficient to cover costs.A total of 80% of the staff in old-age care institutions have college education and bachelor's degrees；the doctors are mainly college educated and bachelor's degree holders；nearly 90.0% of nurses are college graduates and below；94.4% of nursing workers have high school degrees and below；and the persons handling logistics are mostly most high school graduates and below，accounting for 83.7%，and the educational level is generally low.Conclusion　The shortage of hospital beds in facilities providing old-age care combined with medical care in Guangxi，the imbalanced structure of the supply side，and the inadequate payment ability of the elderly have affected the development of the medical care and old-age care industry and the quality of nursing care workers.It is recommended that the development of medical and nursing care in Guangxi be promoted through implementing relevant supporting policies，increasing the services provided by institutions combining old-age and medical care，establishing a long-term care insurance system，and establishing a sound training and incentive structure for the elderly.

Key words: Aged, Medical-nursing combined, Pension institutions, Guangxi