Li WEI, MSSC | Peking Union Medical College Hospital; Chunhou LI, MPH; Lin KANG, MD; Xuan QU, MD; Xin QIAN, MA&MSW
Competition Sponsor: Chinese Academy of Medical Sciences
Awardee Year: 2024
With the growth of aging population in China, the demand for integrated medium and long-term healthcare management for senior patients is increasing, and the requirements for individualized patient care plan is also increasing. Currently, our country is actively building a senior care service system that adapts to an aging society with unprecedented determination and strengths through multi-dimensional measures such as policy guidance, service innovation and social participation, and strives to enable every senior person to enjoy a happy, healthy and dignified aging life.The Social Work Department and the Geriatric Medicine Department in Peking Union Medical College Hospital jointly planned a medium to long-term integrated care referral system for senior patients. It aims to develop care plan and integrate the medium and long-term healthcare services for senior patients when discharging from hospital through a scientific and technological system. The system will integrate clinical medical data and social service resources, and provide individualized health care plans for senior patients upon discharge. This innovation not only improves the accuracy and timeliness of support services. It can also track services, and provide alternative community care options for discharged patients, thereby improving their quality of life. Through the mutual collaboration of medical professionals and medical social workers, the average length of stay and bed occupancy rate can be reduced, and medical efficiency can be improved.The implementation of this system can be a model to other medical institutions, and promote the overall progress of medium to long-term integrated care management services for seniors.