随着我国老龄化问题的日益严重，居家养老作为一种符合我国国情的养老模式被广泛推崇。目前医疗服务是居家养老所面临的重要挑战，基层卫生服务机构的建设和参与是推动居家养老发展的关键。居家养老与基层卫生服务相结合需要众多利益相关主体的协调和配合，现实中基层卫生服务机构参与居家养老服务仍然面临着许多障碍，医养结合的效果不尽如人意。分析各利益相关者的角色、优势和劣势、实施意愿、实施能力及利益诉求，发现阻碍基层卫生服务机构参与居家养老的主要因素是：相关部门职责界定模糊，财政投入不足，人力资源和社会保障部门配套制度不完善，基层卫生服务机构参与积极性低，老年人对基层卫生服务机构信任度低。建议各相关部门明确职责，拓宽投资渠道，加强人才培养，提升基层卫生服务机构的服务能力。%Along with the population ageing worse off continuously, home pension as a pension model in accordance with Chi-na's national conditions is widely respected.Currently, the greatest difficulty faced by the home pension is the medical service.The primary health care institutions construction and participation are the keys for accelerating the construction of home pension .Home pension combined with basic health service need to cooperate with many stakeholders.In reality, primary health institutions partici-pating in home care service are still facing many obstacles, and the effect of combination of medical care and pension is not satisfac-tory.This paper analyzed the stakeholder's attitude, strengths and weaknesses, implementation desire, implementation capacity and their interests and drew a conclusion that the main factors preventing primary health service institution participating in home pension included unclear relevant departments'responsibilities, insufficient capital investment, imperfect supporting policies of human re-source and society insurance departments, primary health service institutions'weak will to participate and the poor trust of elderly to primary health service institutions.We proposed corresponding countermeasures such as making responsibilities of the relevant de-partments clear, broaden the investment channels, strengthening the cultivation of talents to enhance the capacity of primary health service institutions.
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