About print and distribute \"much starker choices-and graver consequences-in\" healthy aging planning advice

Release date: 2017-03-17

Provinces, autonomous regions and municipalities directly under the central government, xinjiang production and construction corps health and family planning commission (bureau of health, population and family planning commission), the national development and reform commission (commission), the department of education, the competent department of industry and information technology, the department (bureau), financial (service) department (bureau), human resources social security department (bureau), the competent department of land and resources, housing construction (appoint, planning land committee, construction bureau), sports bureau, administration of traditional Chinese medicine, disabled persons' federation, aging:

For carrying out the law of the People's Republic of China on the 13th five-year plan for national economic and social development outline of spirit, actively deal with an ageing population, the function of safeguarding the health of the elderly, improve the health status of the elderly, \"\" much starker choices-and graver consequences-in healthy aging\" planning \"is established. Hereby printed and distributed to you, please combined with local and departments work reality, the earnest implementation.

The national health and family planning commission of the national development and reform commission

The ministry of education of the ministry of industry and information technology

The ministry of civil affairs ministry of finance

Human resources social security ministry of land and resources

State general administration of sports of housing urban and rural development

National bureau of China disabled persons' federation of Chinese medicine the old office

On March 9, 2017

\"Much starker choices-and graver consequences-in\" healthy aging

Healthy aging, that is, from the perspective of the whole process of life, from early life, comprehensive, system of all the factors influencing health intervention, conducive to social support of the elderly health and living environment, to extend the healthy life expectancy, safeguarding the health of the elderly function, improve the health status of the elderly.

\"Much starker choices-and graver consequences-in\" period is the decisive stage to build a well-off society in an all-round way, and the rapid growth of China's aging population, aging pressure of growing period. For coping with an ageing population, to achieve healthy ageing, according to the law of the People's Republic of China on the 13th five-year plan for national economic and social development outline of the \"healthy China 2030\" planning outline \"much starker choices-and graver consequences-in\" national undertaking development and pension system construction plan \", \"\" much starker choices-and graver consequences-in\" deepening the reform of medical health system planning, \"\" much starker choices-and graver consequences-in\" health and health planning \"the elderly education development plan (2016-2020)\" planning requirements, such as planning are formulated.

The background, planning

(a) the achievements of \"twelfth five-year\" period.

1. The framework of the basic form of basic medical security system, medical security level enhances unceasingly. Basic medical insurance system to further improve, realizing a complete coverage of the medical insurance. The final \"twelfth five-year\", China's urban and rural residents (including [1]) in the elderly health care coverage above 95%, welfare level continues to increase, urban and rural residents in the hospital medical expenses policy within the scope of reimbursement ratio reached 75%.

2. Elderly medical and health service system gradually perfect, strengthening service ability. Professional rehabilitation nursing institutions continue to increase. By 2015, the national 453 to build a rehabilitation hospital, nursing home, 168, 65 nursing station, than the \"eleventh five-year plan\" has increased 69.0%, 242.9% and 69.0% respectively. Rehabilitation nursing personnel to further grow. In 2015, rehabilitation hospitals, nursing homes, nursing station, health personnel, respectively for 36441 people, 11180 people, 316 people, than the \"eleventh five-year plan\" has increased 96.5%, 286.7% and 96.5% respectively. Grassroots medical institutions to serve the old continued to deepen, for 65 years of age and above the elderly health management within their respective jurisdictions, 1 time every year for free health checks have a medical examination in 2015 to 118 million the number of elderly. Endowment institutions constantly enhance its capability of medical and health services, 23% of the country's pension institutions with medical institutions, such as the clinic, nursing station.

3. Continuously improve aging health policy, elderly health rights and interests better security. Established in 2014, the state health and family planning commission old-age work leading group, as a whole to promote the elderly health related work. Organizations to carry out the \"Chinese healthy ageing strategy research\", clear the core principles of \"healthy aging\", to focus on the entire life, improve the level of the elderly health and life quality of strategic deployment. Start new family development plan \"capacity building\" and \"old-age care pilot\" the family planning program, focus on training and improve the ability of the family old-age care. In November 2015, the state council on forwarding the health and family planning commission and other departments on promoting health and pension service of combining the guidance \"(countries do hair [2015] no. 84), has been clear about the medical combining work objectives, major tasks and safeguard measures. Documents issued by the various departments after clear division of labor, responsibilities in combination with promptly implement. Health and family planning commission and the ministry of civil affairs jointly issued \"about to do a good job of medical keep combining services license notice, clear first responsibility system, improve the efficiency. Launch a national medical pilot work, selection to determine the 90 pilot cities across the country (area), to explore the establishment conforms to the situation of medical combination service mode. Around the medical work combined with solid start, in the form of a variety of needs of the elderly health endowment provides integrated continuous medical combination of services.

(2) the challenge \"much starker choices-and graver consequences-in\" period.

\"Much starker choices-and graver consequences-in\" period, the population aging population continues to deepen, old age and disability increased number of elderly people, the rigid demand for elderly health services constantly released, along with the change of family structure, bring serious challenges of elderly health services.

1. The aging degree deepening, elderly health services demand is increasing. As of 2015, China has reached 222 million people aged 60 and above, accounting for 16.1% of the population, above 65 years old and with a population of 144 million, accounting for 10.5% of the total population. \"Much starker choices-and graver consequences-in\" period, China's aging population aged 60 and above average annual increase about 6.4 million, by 2020 will reach 255 million, accounting for about 17.8% of the total population. Meanwhile, disability and partial disability old people more and more, the disabled elderly increases year by year, 2015, disability and partial disability old people about 40.63 million people, a disabled old man of 11.358 million. Along with deepening of aging, older people for services such as health care, rehabilitation nursing of rigid demand is increasing. And the aging process, family miniaturization, empty nest accompanied with urbanization, with the economic and social transition period, all kinds of contradictions which and left-behind elderly scale flow steadily on the increase, more and more families facing lack of caregivers. The elderly health services demand has become a \"much starker choices-and graver consequences-in\" during an urgent need to solve an important problem.

2. The elderly health service system, it is necessary to reform the elderly health services provide ability needs to be strengthened. Our country has not set up to meet the needs of the elderly health including care - prevention - treatment - recovery - nursing - comprehensive, continuity of hospice care service system. Elderly health service agencies, rehabilitation hospital, professional rehabilitation institutions for disabled persons and care institutions such as the limited and region distribution, alzheimer care, hospice care institutions such as serious lack of, for the community and home the old man's ability to provide health services needs to be strengthened. The number of people in the elderly health service is insufficient, especially the serious lack of high-quality professionals at the basic level. D combined with service work has just started, policy system is not perfect, needs to improve the evaluation system to the elderly health.

3. The elderly health care policy needs to improve efficiency, the elderly health system needs to be further perfected. The elderly is the medical service using the high frequency of the crowd, the elderly outpatient and hospitalization demand and medical costs were higher than social average level. The elderly health care system in our country, on the whole, still lag behind the demands of the development of an ageing population and social policy efficiency is not high, especially that of the elderly, the disabled elderly in urgent need of long-term care insurance system has not yet been established, the old sources of long term care costs no institutional protection.

Second, the guiding ideology, basic principles and development goals

(a) the guiding ideology. Fully implement the party's 18 large and 18 sixth plenary session of 3, 4, 5, spirit, in-depth implementation of xi jinping, general secretary of the series of important speech and the national health and health conference spirit, to maintain the rights and interests of the elderly health and satisfy the elderly health services demand as the starting point and the foothold, and vigorously promote the elderly health service supply side structural reforms and way to realize development by treating centered to people's health as the center, service system by the diagnosis ability is given priority to in order to improve the elderly to give priority to with a complete coverage of whole life cycle, health service, to ensure the elderly access to appropriate, integrated, continuous integrated health services, improve the level of the elderly health, achieve healthy aging, construction of health in China.

(2) the basic principles.

1. People-oriented, improve people's livelihood. To improve the elderly health level as the goal, in line with does the practical work for the elderly, do a good turn, out of principle, give full consideration to the elderly health characteristics and demands, to meet the growing demand of health in the elderly, improve the quality of the elderly health life.

2. The government guidance, social participation. Active play to the government in planning, policies, guide the investment, standardize services, supervision and management responsibilities, accelerate the elderly health service system construction. Plays a decisive role in the allocation of resources, mobilize the power of the specialization of social organizations, stimulating social vitality, encourage social investment, multi-level, diversified health care of demand.

3. Adjust measures to local conditions, highlight the key. According to the development level, combined with the material and spiritual and cultural needs of the elderly, classification, multi-level, targeted for health services. Focus on the needs of the economic difficulties of disability, alzheimer, family planning, special care family of the elderly health care and service work.

4. The integration of resources, overall consideration. Overall urban and rural resources, play a fundamental role of urban and rural communities, and promote the combination of medical and health care and pension services. Overall health and pension service resources, to achieve win-win cooperation.

(3) the development goals.

During the period of \"much starker choices-and graver consequences-in\", the national economic and social development goals, optimizing the resources distribution of elderly health care, to strengthen publicity and education, prevention, health care, medical treatment, rehabilitation nursing, medical combination and hospice care work, establish a basic medical and health care system covering urban and rural elderly people, building and national economic and social development that meet the needs of the elderly health service system, continue to improve the elderly health.

- fair, both quality and elderly public health service system constantly improve, improve the elderly health service level.

- orderly, the elderly health service system of integrated continuous basic formation, for the elderly to provide comprehensive integrated service continuously, basic meet the demand of the elderly health services.

- more fair, more sustainable improvement system of basic medical insurance system, to establish long-term care insurance system.

-- elderly health related policy system more perfect, healthy aging all-round and sustainable development in all fields of endeavor.

Three, the main task

Around the focus of the elderly health work difficulty and the weak link, the elderly health service as the central task, optimizing the resources distribution of elderly health and pension and layout, filling, accelerate the integrated elderly health service system construction.

(a) promote the elderly health promotion and education work, improve the elderly health literacy.

1. Strengthen the elderly health education. To carry out the elderly fitness, elderly care, old age diseases prevention and rehabilitation, science, culture, psychological health, vocational skills education activities, family financial management, etc. Sound around the elderly fitness organization, enrich the old side of sports fitness activities, sports fitness events around support for the elderly, the construction of the elderly sports fitness facilities around, to strengthen the elderly around sports fitness guidance, promote the elderly health around culture. Advocate healthy way of life, improve the health level and quality of life of old people. Positive development of community elderly education and guide to carry out, travel, reading, lectures, learning community volunteer service, and other forms of old education activities, to promote whole society advocated the concept of healthy aging, build elderly friendly social atmosphere. The elderly health care knowledge into the community, into the family activities, according to the characteristics of the elderly to develop elderly health education textbooks, positive publicity is suitable for the elderly of traditional Chinese medicine health care methods, strengthen the elderly self-help communal health emergency skill training.

(2) strengthen the elderly health public health service work, improves the management level of the elderly health.

2. To do a good job of senile disease prevention. Do a good job in the national basic public health services of the elderly health management service work, adjust the elderly health physical examination project and content. Promote the senile dementia, fall prevention and control of appropriate technology such as, constipation, urinary incontinence, in old age common diseases, chronic diseases, oral disease screening intervention and health guidance, senile disease early detection, early diagnosis, early treatment, promote the function of the elderly health.

3. Promote the elderly mental health and care services. Start the elderly mental health prevention and intervention programs for poverty, empty nest, disability, alzheimer, family planning, special family and the elderly living alone the elderly daily care and psychological support services. To strengthen the community management of elderly patients with severe mental disorders and the rehabilitation, encourage old people to take an active part in social activities, promote mental health in the elderly.

(3) improve the elderly health service system, improve the quality of service and accessibility.

4. To strengthen the medical and health service system in the service of the function in the elderly. Strengthen the rehabilitation hospitals, nursing homes and comprehensive geriatrics of hospital construction. To promote grassroots medical and health institutions actively carry out the elderly services such as health care, rehabilitation, nursing, family sickbed, improve the accessibility of medical and health services in the elderly. Promote the development of hospice care services. Advocates for the elderly yizhen, provide door-to-door service for disabled elderly people. Is established in 2020, the medical establishment for the elderly to provide convenient services such as registration, the green channel.

(4) actively promote the medical combination of services, improve the utilization efficiency of social resources configuration and.

5. Develop the medical combination of services. Establish and improve the medical and health institutions and pension institutions cooperation mechanism, encourage various forms of signing service, cooperation agreement. Support conditional of the pension institution as stipulated in the relevant application start rehabilitation hospitals, nursing homes, hospice care, Chinese medicine hospital institutions or clinic, nursing station, etc., the key for the fail, wise old man to provide the needed medical care and life care services. Public hospital resource-rich regions can be actively and steadily to convert part of the public hospital geriatric rehabilitation, such as elderly care institutions. Promoting health service extending to the community and family. Promote the medical and health institutions and medical personnel to establish the contract signing relationship with old man that occupy the home, continuity of health management and medical services for the elderly. Improve grassroots medical institutions for the old man's ability to provide door-to-door service at home. Encourage social forces in a variety of forms to carry out medical combination of services. Research on the elderly health classification standard, improve the relevant service standard, the standard of the management and supervision and evaluation mechanism, research and development of the corresponding quality control measures.

6. Promote the development of the elderly long-term care services that occupy the home. To strengthen the grassroots health service network functions, actively promote the family doctor signing service, for the elderly to provide comprehensive, continuous, synergy and normative basic medical and public health services. Make full use of community health service system, cultivate social nursing staff team, to provide long-term care services for older people that occupy the home, to provide care for family members training, exploring from home and community to professional institutions of perfecting system of long-term care services.

7. To strengthen the elderly health related research work. Large cohort study, study to judge and predict the elderly health indicators, standards and methods, research and development of wearable elderly health support technology and equipment. Exploration of comorbidity of syndrome and disease process and law of development of appropriate technologies for the prevention and control, guide and standardize, build elderly health management network.

(5) to strengthen the construction of medical security system and lay a solid foundation for the maintenance of the elderly health.

8. Improve the basic medical security system, strengthen their security level. Full implementation of urban and rural residents of a serious illness insurance system. On the basis of local pilot, explore to establish long-term care insurance system. Implement qualified settlement is directly across the province the elderly health care costs of different ground be in hospital. Encourage the development and the elderly commercial health insurance, basic medical insurance of corresponding meet diversified, multi-level health care needs of the elderly.

9. To further intensify of poor elderly medical treatment. In low object and strands personnel based on the elderly medical relief work, incorporating the elderly low-income families into the scope of medical aid shift diseases. To conform to the conditions of family planning special difficult family to the old give corresponding medical treatment.

(6) to play () national medicine of traditional Chinese medicine characteristics, to provide diversified elderly health services.

10. The old people () national medicine of traditional Chinese medicine health management services. Expand TCM health management service project covers the breadth and depth, and constantly enrich the content of the old Chinese medicine health guidance, promote the elderly TCM constitution identification services, according to the different physique and the health status of traditional Chinese medicine (TCM) to provide more health care, disease prevention and control of health guidance, etc.

11. Promote the development of traditional Chinese medicine () national medicine characteristic medical combination of services. Encourage new with pension is given priority to traditional Chinese medicine health care, nursing homes, conditional endowment institutions is given priority to with aging, chronic disease prevention and control of traditional Chinese medicine clinic. Promote the traditional Chinese medicine hospitals, elderly care and rehabilitation rehabilitation institutions cooperation. Promote level 2 above hospitals of traditional Chinese medicine geriatrics, to increase the number of elderly sickbed, geriatrics, chronic disease prevention and rehabilitation nursing, priority preferential service for old people go to a doctor. To promote the traditional Chinese medicine health resources into the pension institutions, communities and households. Support pension agency to carry out the integration of traditional Chinese medicine characteristics of elderly health care, medical care, rehabilitation, nursing service. Support pension institutions cooperate with medical institutions of traditional Chinese medicine. Encourage social capital to (new) to pension is given priority to traditional Chinese medicine health care, nursing homes, exploring to establish a number of characteristics of traditional Chinese medicine medical combination service demonstration base.

(7) to the elderly diversification demand as the guidance, promoting the development of elderly health industry.

12. Develop elderly health industry. Combining with the characteristics of old people body and mind and vigorously promote health keeping in good health, physical examination, consulting management, determination of physique and physical fitness, sports rehabilitation, medical tourism, and other diversified health services. Vigorously promote medicines, medical equipment, rehabilitation equipment, health supplies, health food, elderly fitness products such as research and development manufacturing technology level, expand the scale of health service related industries.

13. Promote the development of information technology to support a healthy pension and health development of wisdom endowment new formats. Full use of the Internet, the Internet of things, big data, such as information technology, innovation, healthy endowment service mode, the wisdom of the geared to the needs of families, communities, health pension application demonstration, promote efficiency of health care coverage and quality. Build wisdom healthy endowment service platform, all levels of medical and health care and pension service resources docking, establish elderly health dynamic monitoring mechanism, integration of information resources, realize information sharing, for the elderly health guidance, slow disease management, security monitoring, etc. Pushing forward the construction of the medical institutions telemedicine old-age population to provide convenient service for your organization.

(eight) old and promote optimal health support environment construction, build elderly friendly social atmosphere.

14. Promote the elderly livable environment construction. Construction of the old society participation support environment, from the various aspects of is closely related to elderly health, optimize \"living, transportation, medical,\" such as the environment, to create a safe, convenient, comfortable, barrier-free elderly livable environment system. Promote the elderly residential optimal aging transformation, support for old residential construction. To carry forward and helpage social fashion, to respect, to strengthen the family endowment function, perfect the family endowment policy support system.

(9) to strengthen the construction of professional team, improve the level of specialization and professionalization of team.

15. Strengthen the elderly health services personnel team construction, and cultivate a batch of caring as soon as possible, understand technology, will manage the elderly health service workers. The geriatric medicine, rehabilitation, nursing talents as are in urgent need of talented person into the health to family planning personnel training plan, strengthen professional skills training, vigorously promote the old-age care workers, professional skill appraisal work. Take positive measures to guarantee the legitimate rights and interests of nursing staff, reasonable and gradually improve their wages. Support for institutions of higher learning and courses in related professional or vocational colleges, to speed up the cultivation of geriatric medicine, rehabilitation, nursing, nutrition, psychological and social work professionals. Encourage medical have combined with service agencies to participate in the whole process of talent training, practice and teachers provide jobs for students. A batch of vocational colleges focus on health service classes and pension service model professional.

Fourth, safeguard measures

(a) to strengthen organization and leadership. Shall attach highly importance to the problem of aging population, strengthening the work plan for the elderly health. Real \"much starker choices-and graver consequences-in\" healthy aging planning into the important agenda, included in the overall economic and social development planning, timely solve major problems in the elderly health service system construction, the elderly health industry development as to promote industrial structure adjustment, the main content of the economy and expanding employment. Improve the government leading, departments, collaboration, working mechanism of social participation. Everywhere want to combine the actual plan of \"much starker choices-and graver consequences-in\" healthy aging and concrete measures for its implementation.

(2) intensify policy support. Around to actively support policy, promote the realization of \"much starker choices-and graver consequences-in\" healthy aging planning objectives. Further increase government financial input and support the elderly health service infrastructure. In investment and financing, land supply, the implementation of the tax benefits, talent training, policy guarantee of elderly health service support and tilt, specific policy on government purchase services.

(3) strengthen the sector collaboration. Family planning and national development and reform at all levels of health, education, industry and information technology, civil affairs, finance, human resources, social security, urban and rural construction land and resources, housing, sports, management, disabled persons' federation of Chinese medicine, aging and other departments to strengthen coordination, division of labor cooperation, to carry out the elderly health policies, provide support to achieve the healthy aging planning goal together.

(4) play a role of social forces. Support social capital into the elderly health industry market, encourage social forces to actively initiate old age health services, to provide elderly health services. Actively guide and support social service agencies, public welfare charity and voluntary service organizations and other social organizations to carry out the elderly health care service activities. Give full play to the basic old age association, organize the elderly to develop mutual help activities. Support the professional social workers organizations of various kinds of love, care for the elderly to carry out the \"YiZhuYi\" \"more than help a variety of forms such as\" the pairing care service activities.

(5) establish examination evaluation system. Establish and improve the monitoring and assessment mechanism, regular monitoring and major projects, the implementation of major projects. Build system of middle and late evaluation, organization to carry out the planning and implementation progress and implementation effect of the comprehensive assessment.

[1] in this paper, in addition to the special mark, the elderly refers to the population of 60 and above.