国家卫健委出台最新版医养结合示范项目工作方案-政策解读-医院绩效咨询,医院绩效管理,医院管理咨询 -九鼎医院管理顾问

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行业新闻

国家卫健委出台最新版医养结合示范项目工作方案

提交者：发表时间：2025-7-23点击次数：707来源:国家卫健委

为贯彻落实党中央、国务院关于医养结合工作的决策部署，推进医养结合高质量发展，更好顺应老年人健康养老服务需求，根据国家卫生健康委等部门《关于进一步推进医养结合发展的指导意见》（国卫老龄发〔2022〕25号）、《关于促进医养结合服务高质量发展的指导意见》（国卫老龄发〔2024〕40号）等文件，国家卫生健康委组织开展医养结合示范项目创建工作，工作方案如下。

一、创建目标

通过创建全国医养结合示范县（市、区）和示范机构，总结推广好的经验和做法，发挥示范引领、辐射带动作用，鼓励各地深入推进医养结合工作，引导更多社会力量积极参与，不断扩大和优化医养结合服务供给，提高医养结合服务能力和水平，更好顺应老年人健康养老服务需求。

二、创建范围

（一）全国医养结合示范县（市、区）。鼓励各地条件成熟、工作基础好的县、县级市、市辖区积极开展创建工作。示范县（市、区）每2年评估一次，每次命名100个左右，2030年完成创建工作。

（二）全国医养结合示范机构。具备医疗卫生机构资质，依法进行养老机构备案的医疗卫生机构或养老机构。示范机构每2年评估一次，每次命名100个左右（含中医药特色的示范机构），2030年完成创建工作。

三、创建标准

（一）全国医养结合示范县（市、区）

1.党政重视，部门协同。贯彻落实国家有关医养结合政策文件，制定本级推进医养结合工作方案，坚持公益性原则，将医养结合工作作为改善民生的重要内容纳入当地经济社会发展规划，纳入深化医药卫生体制改革和促进养老服务发展的总体部署。建立医养结合工作机制，各部门分工明确，责任到位，形成多部门协同、全社会参与的工作格局。

2.政策支持，推动有力。落实医养结合投融资、用地、审批登记、价格、财税优惠等公益性运行保障政策措施。用于社会福利事业的彩票公益金可按规定适当支持开展医养结合服务。完善基本医疗保险等管理措施。制定出台人员培养培训、信息化等相关支持性措施。鼓励社会力量兴办医养结合机构，通过公建民营或民办公助等多种模式支持社会力量参与医养结合，为老年人提供多层次、多样化的健康养老服务，以及基本医疗和基本公共卫生等服务。

3.固本强基，优化提升。以医养签约合作、医疗卫生机构开展医养结合服务、养老机构开展医疗卫生服务、医疗卫生服务延伸至社区和家庭等多种模式依法依规深化医养结合。大力推进居家和社区医养结合，开展社区医养结合能力提升行动，落实国家基本公共卫生服务老年人健康管理、老年人中医药健康管理、老年健康与医养结合服务项目、家庭医生签约服务、家庭病床服务等有关要求，鼓励支持医疗卫生机构按照相关规范、标准为居家老年人提供上门医疗卫生服务。充分发挥中医药在健康养老中的优势和作用，推广中医药适宜技术产品和服务，增强社区中医药医养结合服务能力。支持将医养结合机构纳入紧密型医联体统一管理。加强医疗养老资源共享，推进农村地区医养结合，鼓励基层医疗卫生机构与养老服务设施统筹规划、毗邻建设，基本满足农村老年人健康养老服务需求。二级及以上综合性医院开设老年医学科的比例超过全国平均水平。引导支持医疗资源丰富地区的部分二级及以下医疗卫生机构转型为康复医院、护理院，引导支持县区级医疗卫生机构延伸开展医养结合服务。本地区所有养老机构能够以不同形式为入住老年人提供医疗卫生服务，医疗卫生机构普遍建立老年人挂号、就医绿色通道。

4.严格管理，强化监督。落实医养结合相关规范性文件及标准等。加强部门联合监管，纳入卫生健康、养老行业监督抽查范围以及安全生产和消防安全工作总体部署，按照职责对医养结合机构中的医疗卫生机构和养老机构进行行业监管。定期对医养结合机构服务质量进行检查评估，指导医养结合机构严格执行相关规章制度、诊疗规范和技术规程，对发现的问题及时跟踪检查、督促整改。指导医养结合机构加强感染管理和传染病防控工作。医养结合数据准确并能有效用于指导实际工作。

5.完善支撑，加强保障。医养结合机构的医务人员享有与其他医疗卫生机构同等的职称评定、专业技术人员继续教育等待遇。出台支持政策，鼓励医务人员到医养结合机构执业，建立医养结合机构医务人员进修轮训机制。公立医疗卫生机构在内部绩效分配时，对完成居家医疗服务、医养结合签约等服务较好的医务人员给予适当倾斜。推进“互联网＋医养结合”，充分利用现有服务平台，推进医疗、养老服务信息互联互通和数据共享。运用互联网等技术开展医疗、养老服务，能够为老年人提供针对性、便捷性的医养结合服务。开展医养结合相关培训项目，支持就业重点群体参加培训并到相关机构就业。培育和支持助老志愿服务，开展面向医养结合机构的志愿服务。

6.群众认可，评价良好。医养结合服务得到当地老年人的普遍认可，5年内无医疗质量安全和涉老等重大负面事件。医养结合工作得到上级主管部门和相关部门的肯定，媒体评价良好。

医院绩效咨询

（二）全国医养结合示范机构

运营满5年及以上（以取得资质时间为准），近2年入住率达到实际运营床位的65%及以上，能为入住老年人提供适宜的预防期保健、患病期治疗、康复期护理、稳定期生活照料以及临终期安宁疗护一体化的医养结合服务，入住失能、失智老年人占比超过65%。在满足以上条件的基础上，优先推荐符合以下条件的机构：开展老年人健康和需求综合评估，建立老年人电子健康档案，医疗和养老服务提供者共享综合评估结果；开展健康教育、健康管理，对老年疾病开展早期干预，预防或减缓失能失智；开展居家和社区医养结合服务；为老年人家庭照护者提供心理干预、培训和支持；注重发挥中医药特色和优势，推广中医适宜技术，为老年人提供中医体质辨识、中医药诊断治疗、康复护理、养生保健、健康管理等服务；利用信息化手段提升医养结合服务质量和效率。

1.环境设施好。按照机构类别，服务场地的建筑设计符合相关医疗机构建筑设计规范及《老年人照料设施建筑设计标准》《建筑设计防火规范》《无障碍设计规范》等国家相关标准要求。根据医疗机构和养老机构相关标准规范配备满足服务需求的医疗和养老设施设备，定期进行维护和保养，确保设备安全使用。

2.人员队伍好。按照机构类别、规模和服务需求等配备相应的管理、专业技术、服务和后勤人员，人员配备数量符合国家有关要求，所有人员均须按照国家相关法律法规规定持证上岗，或经相关专业培训合格后方可上岗并组织定期考核。管理人员应当具备相关管理经验。各类专业技术人员应当建立专业技术档案。有健全的人员培训制度，对相关人员组织开展培训，持续提升服务能力。

3.内部管理好。强化质量安全管理主体责任，全面落实诊疗规范和行业标准，健全质量管理体系。遵循《医疗机构管理条例》《养老机构服务质量基本规范》《医养结合机构管理指南（试行）》等相关制度规范，建立与医养结合服务相配套的管理体系，建立健全质量安全管理制度、人员岗位责任制度和服务管理制度，加强服务管理、人员管理、财务管理、环境及设施设备管理、安全生产管理和后勤管理等；医疗卫生机构要加强医疗管理、护理管理、药事管理、院感管理、医疗文书管理等。落实传染病防控和安全生产责任，建立健全安全生产责任制、安全生产规章制度、安全生产教育培训制度、安全生产应急管理制度等。落实消防安全责任制，制定本单位的消防安全制度、消防安全操作规程，组织防火检查，结合实际制定灭火和应急疏散预案。

4.服务质量好。遵循《医养结合机构服务指南（试行）》开展服务。了解老年人健康状况，为老年人制定有针对性的个人服务计划，提供专业、安全、规范的医疗卫生服务和养老服务，根据机构职责和服务需求，提供健康教育、健康管理、疾病诊治、康复护理、生活照料、膳食营养、清洁卫生、洗涤、文化娱乐、心理精神支持、安宁疗护等服务，做到慢病有管理、急病早发现、小病能处理、大病易转诊。公开服务项目、服务内容和收费标准，建立投诉反馈机制，积极改进服务质量。参照相关床位转换标准等要求，做好服务的转介与衔接。老年人医疗与养老服务信息共享共用，加强老年人隐私保护。按要求对入住老年人和工作人员开展健康监测和聚集性疫情监测，及时向辖区疾病预防控制机构报告。

5.服务效果好。遵守国家法律法规和相关政策，5年内未发生重特大安全生产事故、较大及以上火灾事故、重大医疗事故和违法案件。坚持公益性原则，机构运营现状良好，具有可持续发展的潜力，产生良好社会效益，能够对其他医养结合服务机构起到示范引领、辐射带动效应。入住老年人及家属满意度调查结果在95%及以上。

四、工作流程

认真贯彻落实中央关于为基层减负的要求，在申报、推荐、验收过程中创新工作方法、优化工作流程，充分利用信息化手段抓取数据，切实减轻基层负担。

（一）自评申报。各申报单位依据工作标准逐项进行对照自查，符合条件的，可填写申报表，逐级报送至省级卫生健康委。

（二）省级推荐。各省（自治区、直辖市）及新疆生产建设兵团卫生健康委对申报单位进行严格初评，确定拟推荐名单，书面报送至国家卫生健康委。

（三）评估验收。国家卫生健康委对推荐单位组织开展评估验收。

（四）公示命名。根据评估验收情况，确定候选示范县（市、区）和示范机构名单，在国家卫生健康委网站进行公示。对公示无异议的，由国家卫生健康委发文命名为“全国医养结合示范县（市、区）”“全国医养结合示范机构”，并予以公布。

（五）动态管理。对示范县（市、区）和示范机构进行动态管理，如发生造成严重社会影响的负面事件、违法案件或医养结合相关政策执行不力、服务水平明显下降、老年人权益受到侵害等情况，及时按程序取消示范县（市、区）或示范机构称号，且3年内不得申请创建示范县（市、区）和示范机构。

武汉九鼎医院管理顾问是一家集医院发展战略、医院文化、医院人力资源、医院绩效管理等咨询模块为一体的医院管理咨询公司。如有咨询需求请拨打热线：027-82444583。

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_SERVER["SCRIPT_FILENAME"]	D:\wwwroot\yyjg.net\wwwroot\admin.php
_SERVER["REQUEST_URI"]	/admin.php/index/view/aid/14987.html
_SERVER["REQUEST_METHOD"]	GET
_SERVER["REMOTE_USER"]	no value
_SERVER["REMOTE_PORT"]	52410
_SERVER["REMOTE_HOST"]	216.73.216.49
_SERVER["REMOTE_ADDR"]	216.73.216.49
_SERVER["QUERY_STRING"]	no value
_SERVER["PATH_TRANSLATED"]	D:\wwwroot\yyjg.net\wwwroot\admin.php\index\view\aid\14987.html
_SERVER["PATH_INFO"]	/index/view/aid/14987
_SERVER["LOGON_USER"]	no value
_SERVER["LOCAL_ADDR"]	172.16.121.93
_SERVER["INSTANCE_META_PATH"]	/LM/W3SVC/1
_SERVER["INSTANCE_NAME"]	WWWROOT
_SERVER["INSTANCE_ID"]	1
_SERVER["HTTPS_SERVER_SUBJECT"]	CN=www.yyjg.net
_SERVER["HTTPS_SERVER_ISSUER"]	C=PL, O=Asseco Data Systems S.A., CN=Certum DV TLS G2 R39 CA
_SERVER["HTTPS_SECRETKEYSIZE"]	2048
_SERVER["HTTPS_KEYSIZE"]	256
_SERVER["HTTPS"]	on
_SERVER["GATEWAY_INTERFACE"]	CGI/1.1
_SERVER["DOCUMENT_ROOT"]	D:\wwwroot\yyjg.net\wwwroot
_SERVER["CONTENT_TYPE"]	no value
_SERVER["CONTENT_LENGTH"]	0
_SERVER["CERT_SUBJECT"]	no value
_SERVER["CERT_SERIALNUMBER"]	no value
_SERVER["CERT_ISSUER"]	no value
_SERVER["CERT_FLAGS"]	no value
_SERVER["CERT_COOKIE"]	no value
_SERVER["AUTH_USER"]	no value
_SERVER["AUTH_PASSWORD"]	no value
_SERVER["AUTH_TYPE"]	no value
_SERVER["APPL_PHYSICAL_PATH"]	D:\wwwroot\yyjg.net\wwwroot\
_SERVER["APPL_MD_PATH"]	/LM/W3SVC/1/ROOT
_SERVER["IIS_UrlRewriteModule"]	7.1.0871.0
_SERVER["HTTP_USER_AGENT"]	Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
_SERVER["HTTP_HOST"]	www.yyjg.net
_SERVER["HTTP_COOKIE"]	PHPSESSID=v6ebl53f2nc0jel53lirhfnnf5
_SERVER["HTTP_ACCEPT_ENCODING"]	gzip, br, zstd, deflate
_SERVER["HTTP_ACCEPT"]	/
_SERVER["HTTP_CONNECTION"]	close
_SERVER["FCGI_ROLE"]	RESPONDER
_SERVER["PHP_SELF"]	/admin.php/index/view/aid/14987.html
_SERVER["REQUEST_TIME_FLOAT"]	1789713532.1747
_SERVER["REQUEST_TIME"]	1789713532

PHP Authors
Contribution	Authors
Zend Scripting Language Engine	Andi Gutmans, Zeev Suraski, Stanislav Malyshev, Marcus Boerger, Dmitry Stogov, Xinchen Hui, Nikita Popov
Extension Module API	Andi Gutmans, Zeev Suraski, Andrei Zmievski
UNIX Build and Modularization	Stig Bakken, Sascha Schumann, Jani Taskinen
Windows Port	Shane Caraveo, Zeev Suraski, Wez Furlong, Pierre-Alain Joye, Anatol Belski
Server API (SAPI) Abstraction Layer	Andi Gutmans, Shane Caraveo, Zeev Suraski
Streams Abstraction Layer	Wez Furlong, Sara Golemon
PHP Data Objects Layer	Wez Furlong, Marcus Boerger, Sterling Hughes, George Schlossnagle, Ilia Alshanetsky
Output Handler	Zeev Suraski, Thies C. Arntzen, Marcus Boerger, Michael Wallner

SAPI Modules
Contribution	Authors
AOLserver	Sascha Schumann
Apache 1.3 (apache_hooks)	Rasmus Lerdorf, Zeev Suraski, Stig Bakken, David Sklar, George Schlossnagle, Lukas Schroeder
Apache 1.3	Rasmus Lerdorf, Zeev Suraski, Stig Bakken, David Sklar
Apache 2.0 Filter	Sascha Schumann, Aaron Bannert
Apache 2.0 Handler	Ian Holsman, Justin Erenkrantz (based on Apache 2.0 Filter code)
Caudium / Roxen	David Hedbor
CGI / FastCGI	Rasmus Lerdorf, Stig Bakken, Shane Caraveo, Dmitry Stogov
CLI	Edin Kadribasic, Marcus Boerger, Johannes Schlueter, Moriyoshi Koizumi, Xinchen Hui
Continuity	Alex Leigh (based on nsapi code)
Embed	Edin Kadribasic
FastCGI Process Manager	Andrei Nigmatulin, dreamcat4, Antony Dovgal, Jerome Loyet
ISAPI	Andi Gutmans, Zeev Suraski
litespeed	George Wang
NSAPI	Jayakumar Muthukumarasamy, Uwe Schindler
phpdbg	Felipe Pena, Joe Watkins, Bob Weinand
phttpd	Thies C. Arntzen
pi3web	Holger Zimmermann
Sendmail Milter	Harald Radi
thttpd	Sascha Schumann
tux	Sascha Schumann
WebJames	Alex Waugh

Module Authors
Module	Authors
BC Math	Andi Gutmans
Bzip2	Sterling Hughes
Calendar	Shane Caraveo, Colin Viebrock, Hartmut Holzgraefe, Wez Furlong
COM and .Net	Wez Furlong
ctype	Hartmut Holzgraefe
cURL	Sterling Hughes
Date/Time Support	Derick Rethans
DB-LIB (MS SQL, Sybase)	Wez Furlong, Frank M. Kromann
DBA	Sascha Schumann, Marcus Boerger
DOM	Christian Stocker, Rob Richards, Marcus Boerger
enchant	Pierre-Alain Joye, Ilia Alshanetsky
ereg	Rasmus Lerdorf, Jim Winstead, Jaakko Hyvätti
EXIF	Rasmus Lerdorf, Marcus Boerger
fileinfo	Ilia Alshanetsky, Pierre Alain Joye, Scott MacVicar, Derick Rethans
Firebird driver for PDO	Ard Biesheuvel
FTP	Stefan Esser, Andrew Skalski
GD imaging	Rasmus Lerdorf, Stig Bakken, Jim Winstead, Jouni Ahto, Ilia Alshanetsky, Pierre-Alain Joye, Marcus Boerger
GetText	Alex Plotnick
GNU GMP support	Stanislav Malyshev
Iconv	Rui Hirokawa, Stig Bakken, Moriyoshi Koizumi
IMAP	Rex Logan, Mark Musone, Brian Wang, Kaj-Michael Lang, Antoni Pamies Olive, Rasmus Lerdorf, Andrew Skalski, Chuck Hagenbuch, Daniel R Kalowsky
Input Filter	Rasmus Lerdorf, Derick Rethans, Pierre-Alain Joye, Ilia Alshanetsky
InterBase	Jouni Ahto, Andrew Avdeev, Ard Biesheuvel
Internationalization	Ed Batutis, Vladimir Iordanov, Dmitry Lakhtyuk, Stanislav Malyshev, Vadim Savchuk, Kirti Velankar
JSON	Omar Kilani, Scott MacVicar
LDAP	Amitay Isaacs, Eric Warnke, Rasmus Lerdorf, Gerrit Thomson, Stig Venaas
LIBXML	Christian Stocker, Rob Richards, Marcus Boerger, Wez Furlong, Shane Caraveo
mcrypt	Sascha Schumann, Derick Rethans
MS SQL	Frank M. Kromann
Multibyte String Functions	Tsukada Takuya, Rui Hirokawa
MySQL driver for PDO	George Schlossnagle, Wez Furlong, Ilia Alshanetsky, Johannes Schlueter
MySQL	Zeev Suraski, Zak Greant, Georg Richter, Andrey Hristov
MySQLi	Zak Greant, Georg Richter, Andrey Hristov, Ulf Wendel
MySQLnd	Andrey Hristov, Ulf Wendel, Georg Richter, Johannes Schlüter
OCI8	Stig Bakken, Thies C. Arntzen, Andy Sautins, David Benson, Maxim Maletsky, Harald Radi, Antony Dovgal, Andi Gutmans, Wez Furlong, Christopher Jones, Oracle Corporation
ODBC driver for PDO	Wez Furlong
ODBC	Stig Bakken, Andreas Karajannis, Frank M. Kromann, Daniel R. Kalowsky
OpenSSL	Stig Venaas, Wez Furlong, Sascha Kettler, Scott MacVicar
Oracle (OCI) driver for PDO	Wez Furlong
pcntl	Jason Greene, Arnaud Le Blanc
Perl Compatible Regexps	Andrei Zmievski
PHP Archive	Gregory Beaver, Marcus Boerger
PHP Data Objects	Wez Furlong, Marcus Boerger, Sterling Hughes, George Schlossnagle, Ilia Alshanetsky
PHP hash	Sara Golemon, Rasmus Lerdorf, Stefan Esser, Michael Wallner, Scott MacVicar
Posix	Kristian Koehntopp
PostgreSQL driver for PDO	Edin Kadribasic, Ilia Alshanetsky
PostgreSQL	Jouni Ahto, Zeev Suraski, Yasuo Ohgaki, Chris Kings-Lynne
Pspell	Vlad Krupin
Readline	Thies C. Arntzen
Recode	Kristian Koehntopp
Reflection	Marcus Boerger, Timm Friebe, George Schlossnagle, Andrei Zmievski, Johannes Schlueter
Sessions	Sascha Schumann, Andrei Zmievski
Shared Memory Operations	Slava Poliakov, Ilia Alshanetsky
SimpleXML	Sterling Hughes, Marcus Boerger, Rob Richards
SNMP	Rasmus Lerdorf, Harrie Hazewinkel, Mike Jackson, Steven Lawrance, Johann Hanne, Boris Lytochkin
SOAP	Brad Lafountain, Shane Caraveo, Dmitry Stogov
Sockets	Chris Vandomelen, Sterling Hughes, Daniel Beulshausen, Jason Greene
SPL	Marcus Boerger, Etienne Kneuss
SQLite 3.x driver for PDO	Wez Furlong
SQLite3	Scott MacVicar, Ilia Alshanetsky, Brad Dewar
Sybase-CT	Zeev Suraski, Tom May, Timm Friebe
System V Message based IPC	Wez Furlong
System V Semaphores	Tom May
System V Shared Memory	Christian Cartus
tidy	John Coggeshall, Ilia Alshanetsky
tokenizer	Andrei Zmievski, Johannes Schlueter
WDDX	Andrei Zmievski
XML	Stig Bakken, Thies C. Arntzen, Sterling Hughes
XMLReader	Rob Richards
xmlrpc	Dan Libby
XMLWriter	Rob Richards, Pierre-Alain Joye
XSL	Christian Stocker, Rob Richards
Zip	Pierre-Alain Joye, Remi Collet
Zlib	Rasmus Lerdorf, Stefan Roehrich, Zeev Suraski, Jade Nicoletti, Michael Wallner

PHP Documentation
Authors	Mehdi Achour, Friedhelm Betz, Antony Dovgal, Nuno Lopes, Hannes Magnusson, Georg Richter, Damien Seguy, Jakub Vrana, Adam Harvey, Peter Cowburn
Editor	Philip Olson
User Note Maintainers	Daniel P. Brown, Thiago Henrique Pojda
Other Contributors	Previously active authors, editors and other contributors are listed in the manual.

Websites and Infrastructure team
PHP Websites Team	Rasmus Lerdorf, Hannes Magnusson, Philip Olson, Lukas Kahwe Smith, Pierre-Alain Joye, Kalle Sommer Nielsen, Peter Cowburn, Adam Harvey, Ferenc Kovacs, Levi Morrison
Event Maintainers	Damien Seguy, Daniel P. Brown
Network Infrastructure	Daniel P. Brown
Windows Infrastructure	Alex Schoenmaker