Research on Service Optimization Strategy of “Migratory Bird-Style Elderly Care” in Panzhihua City under the Background of Integrated Medical Care ()
1. Introduction
The “Report on the Development of China’s Aging Society and Pension Security (2019)” pointed out that as of the end of 2019, my country’s aging rate has reached 12.6%, an increase of 0.7 percentage points from 11.9% in 2018. As the aging of the population in my country is becoming more and more serious, under the background that ordinary institutions and some families cannot meet the needs of some elderly people, my country has proposed to develop a “combination of medical care and elderly care” for the elderly (Wu, Li, & Ma, 2016), and started medical care in 2015. In order to meet the needs of the elderly for multi-level and diversified health care, we will gradually promote the integration of elderly care services with medical and health care (Wu et al., 2017). In 2016, the National Health and Family Planning Commission and the Ministry of Civil Affairs formally announced the list of the first batch of “national-level medical-care integration pilot” cities in my country. The selected cities involve 25 provinces, municipalities and autonomous regions, and a total of 50 cities (districts) across the country are the first batch of national-level pilot cities for the integration of medical and elderly care (Wang, 2016). The pilot cities in Sichuan Province were finally settled as Ya’an City and Panzhihua City. Panzhihua City is committed to building a “China Sunshine Health City”, with “Sunshine Health” as the composite command and power engine, and grasping the core concept of “health + elderly care”, making full use of Panzhihua’s “six degrees” advantages such as temperature, humidity, height, high yield, cleanliness, and greenness, and vigorously developing characteristic medical care services.
A variety of old-age care methods can give the elderly more choices. Under the background of vigorously developing the integration of medical care and nursing care, Panzhihua City, as a representative city of migratory bird-type elderly care, is booming. Migratory bird-type elderly care means that the elderly leave the city like migratory birds, for the place of residence, choose a more comfortable climate and environment for short-term or long-term, and seasonally go to other places for leisure and elderly care. A new type of elderly care mode (Li & Zeng, 2018). However, seasonal migration will also make Panzhi City’s urban infrastructure construction, medical facilities, community services, transportation, economic development, and cultural development all face challenges. Although the increasingly large “migratory bird-style” elderly care groups in different places can enjoy Panzhihua’s warm climate, but at the same time, problems such as unsatisfactory demand for public services, imperfect development of the elderly care service market, unbalanced regional development, inconvenient transportation, and imperfect support policies have also emerged.
2. The Development Status of “Migratory Bird-Style” Elderly Care Services in Panzhihua City under the Background of the Integration of Medical and Nursing Care
2.1. The Characteristic Medical Care Integration Model Is Basically Formed
Panzhihua City strives to build a highland of regional health care and health care, and summarizes the following four models: one is to build community day care centers for the elderly in hospital wards; The tertiary hospitals signed a service cooperation agreement; the fourth is an integrated service of community medical care based on the family contracted service carried out by the community.
2.2. The Migratory Bird’s Migratory Pension Model Came into Being
Panzhihua’s warm climate has led to the gradual development of the “migratory bird pension model” in Panzhihua. The “migratory bird-style” pension integrates health preservation, medical care and tourism. The main feature is that as the climate changes, the elderly go to a warm and comfortable place for the elderly in winter. In summer, they go to a cool and pleasant place for the elderly (Li, Wang, & Chen, 2015). While the “migratory bird elderly” spend the warm winter in Panzhihua, it also promotes the development of local tourism, health care, medical care, nursing and other industries.
2.3. “Migratory Bird-Style Elderly Care” Service Agencies Gradually Emerge under the Background of the Combination of Medical and Elderly Care
Since Panzhihua City was listed as one of the country’s first pilot cities for the integration of medical and elderly care in 2016, various medical institutions, elderly care institutions, and medical and elderly care organizations have used this as an opportunity to extensively carry out medical and elderly integration work, and Panzhihua Health and Health Management Co., Ltd. has emerged. The company, Panzhihua East District Happy Memory Nursing Home, Panzhihua Hengle Elderly Service Co., Ltd. and other units with distinctive medical and nursing services.
3. Development Advantages of “Migratory Bird-Style” Elderly Care Services in Panzhihua City under the Background of the Integration of Medical and Nursing Care
3.1. Unique Climatic Conditions
Panzhihua City is located in the southernmost part of Sichuan Province. It has a warm climate throughout the year with small temperature differences. The annual average temperature is between 19˚C and 21˚C. There is plenty of sunshine and the average daily sunshine hours are kept at about 8 hours. It is very suitable for the elderly to avoid cold and heat. And pension.
3.2. Distinctive Characteristics of Medical Care Integration
Panzhihua, as one of the first batch of national-level pilot cities for the integration of medical and elderly care selected by Sichuan Province, has distinctive characteristics of the model of the integration of medical and elderly care, and strives to create a regional highland of integrated medical and elderly care. It has exhibited 4 types of integrated medical and elderly care with distinctive characteristics. The model is committed to building a “China Sunshine Health City”.
3.3. Surplus Medical Resources
As of the end of 2019, Panzhihua City had a registered population of 1.0837 million (The People’s Government of Panzhihua City, 2019), but it had 74 hospitals and health centers, 6 disease prevention and control centers, 6 maternal and child health centers, and 7873 hospitals and health centers technical staff (The People’s Government of Panzhihua City, 2021), The city has abundant medical resources.
3.4. Rich Tourism Resources
Panzhihua City is rich in tourism resources, including Gesala National AAAA-level tourist attractions, Ertan National Forest Park National AAAA-level tourist attractions, and Miyi Zhuanxu Longdong Scenic Area, which are national AAA-level tourist attractions.
4. Problems in the “Migratory Bird-Style” Elderly Care Services in Panzhihua City under the Background of the Integration of Medical and Nursing Care
4.1. Complex Settlement Procedures for Medical Insurance in Different Places
Under the “migratory bird-style” pension model, there will be more elderly people who seek medical treatment in different places. The traditional territorial medical insurance management model increases the difficulty of reimbursement for insured persons when seeking medical treatment in other places, and also adds challenges to the settlement of medical treatment in different places by the hospital medical insurance department. Currently, only some hospitals in Panzhihua City can settle settlements in other places, because they cannot cover all the hospitals in Panzhihua City, and the distance between the hospitals is relatively long, causing inconvenience to the settlement of medical insurance for “migratory birds”.
4.2. It Is Difficult to Coordinate Pension Policies, and Social Security Bottlenecks Still Exist
The medical-care integration model is a relatively innovative old-age care model. It is difficult to coordinate the old-age policies and the social security bottleneck still exists. In recent years, although some provinces and cities have gradually promoted the inter-provincial coordination of medical insurance and endowment insurance, and many of them have implemented relevant coordination policies, these two social insurances have not yet achieved cross-provincial and national coordination, and this has been achieved. It is relatively difficult to coordinate on a large scale, and the national laws, regulations and related policies have not yet clarified the various security policies for the elderly in different places. The pension security policies issued by various regions are different, and it is difficult to coordinate the pension security policies between different regions. In addition, the establishment and development of the medical-care integration policy system needs the support of the insurance system. Many cities are currently carrying out long-term care insurance pilot projects. However, under the situation of increasing pressure on the payment of medical insurance funds, most of the current pilot cities still rely on basic medical care. Insurance is used to raise funds, and the lack of independence and stability of financing is not conducive to the overall development of the integrated medical and elderly care service industry.
4.3. Existing Transportation Modes Are Inconvenient
Convenient transportation is an important indicator to measure whether the environment is livable. Panzhihua’s existing transportation modes mainly include airplanes, cars, and high-speed rail. However, the plane tickets to Panzhihua are expensive, and the subway has to detour through Guizhou and Kunming, so most people will choose trains and cars, but the trains and cars take too long, and the elderly should not sit for long due to physical reasons, so the inconvenience of transportation means The travel of the elderly has brought certain difficulties. In addition, the “migratory bird-style” elderly care groups in different places have financial security, have a lot of free time, and travel frequently. Every winter, the public transportation in Panzhihua City will face considerable pressure. The number of passengers increases and the comfort level of travel decreases. These problems indirectly caused the conflicts and contradictions between local residents and the “migratory bird-like” elderly care group in different places.
4.4. Insufficient Publicity
The Panzhihua government currently promotes “sunshine health care” as a key local feature. Many elderly people learn about Panzhihua’s elderly care service industry through recommendations from relatives and friends. The rest of the elderly mainly use corporate publicity, newspapers, television, etc. The number of elderly people who have learned about it through online media and other means that can touch people’s hearts through publicity is relatively small. This fully reflects that Panzhihua’s “migratory bird-style” pension mainly accumulates service targets through more traditional word-of-mouth introductions. This propaganda method is very inefficient and the propaganda effect is unstable. Although the government has issued relevant policies to support it, it is not Panzhihua’s old-age care method did not provide corresponding propaganda assistance. Compared with the already well-known Hainan “migratory bird” service industry, its market popularity is not high. In addition, in Panzhihua’s “migratory bird-style” elderly care services, there are currently no brands with special appeal. Most of them are small-scale elderly care institutions with limited professionalism and limited service levels. It is not attractive enough for the elderly.
4.5. Obvious Differences between Off-Peak and Peak Seasons
Due to the small temperature difference in the four seasons and plenty of sunshine in Panzhihua, autumn and winter are the peak seasons for the elderly to travel and maintain health, generally from October to January of the following year, and the rest of the time is the off-season. During the peak season in Panzhihua, the occupancy rate of senior housing estates is basically above 70%; while in the off-season, the occupancy rate of some senior housing estates is even less than 20%, the difference is very obvious (Wan, 2018). Such a huge difference between the off-peak and peak seasons has made the operation of Panzhihua elderly care institutions more difficult, the fund recovery period has been further lengthened, and the operational risks have further increased. Therefore, the vacancy rate of elderly care institutions in the off-season has become the most troublesome issue.
5. Panzhihua City’s “Migratory Bird-Style” Elderly Care Service Optimization Strategy under the Background of Integrated Medical Care
5.1. Simplify Medical Insurance Settlement Procedures in Different Places
Efforts to break through the system bottleneck of medical insurance for medical treatment in different places. The key factor for the elderly migratory bird to choose migratory bird-style pension is to see a doctor. The biggest system difficulty lies in realizing the direct settlement of medical insurance for medical treatment in different places. At present, the filing procedures in various regions are not unified. To solve this problem, it is necessary to unify and simplify the procedures for medical filing procedures in different regions. You can make full use of “Internet +” technology to simplify services, and use mobile phone software, websites, WeChat public accounts, hospital self-service machines, etc. to carry out online and remote medical filing procedures, effectively reducing a lot of time costs, improving the efficiency of review and filing, and let “migratory birds” as much as possible. “The old man quickly completed the filing procedures”. In addition, Panzhihua City will also increase the census and publicity of relevant medical insurance knowledge, so that the elderly “migratory birds” will be aware of the filing methods in time.
5.2. Guarantee the Welfare of the Elderly Migratory Birds and Improve the Social Security System
The pressure of adapting to the remote environment and climate is far from the problem of social security for the elderly in remote places. The problems of incomplete pension policies and laws, and the inability to effectively guarantee the benefits of the elderly in different places are problems that cannot be ignored in the further development of the new era. To realize the marketization and socialization of old-age care in different places, it needs the support and guidance of national policies to accelerate the improvement of old-age care policies and systems in different places to provide institutional guarantees for old-age care in different places. The local government of Panzhihua City should introduce a strong policy to break the limitations of pension benefits, let welfare policies follow the elderly, promote the establishment of an inter-regional integrated pension welfare mechanism, ensure that the elderly people in different places enjoy the same benefits, and appropriately increase the pension subsidies for elderly people in different places.
5.3. Optimize the Way of Travel for the Elderly of Migratory Birds
Most elderly people who live in migratory birds choose to travel on their own. As the elderly are inconvenient to travel, Panzhihua City should vigorously build a transportation infrastructure system, complete the “13th Five-Year Plan” of Panzhihua City, and accelerate the formation of the the “4-hour economic circle” accelerates the establishment of a regional comprehensive transportation hub, and builds a “Panzhihua regional transportation hub, Panzhihua ecological and livable center, and sunshine health and leisure resort base”. In view of this, the government also needs to consider the seasonality and flexibility of migratory bird-style elderly travel. Start with it and increase convenience for the elderly in winter.
5.4. Build Local Characteristic Brands and Increase Publicity
First of all, Panzhihua should fully accumulate the advantages of the local brand effect, combine the local actual situation, further expand its advantages in the “migratory bird-style” elderly care service under the background of the development of medical and nursing care, and strengthen publicity and promotion to create the core competition of the local elderly care service industry. It has made it a high-level, professional, and Panzhihua elderly care service brand, supporting the publicity center of Panzhihua elderly care real estate. Secondly, it is necessary to strengthen external publicity, especially through some more traditional and credible channels, such as “Panzhihua Daily”, “Panzhihua Evening News”, “Friends of the Elderly” and other newspapers and magazines, and the elderly pay more attention to it. TV and radio programs, such as “Voices of the Elderly”, have gradually expanded the popularity and influence of Panzhihua Pension Real Estate. Finally, you can also cooperate with well-known elderly care service organizations in the country, such as Qinheyuan, and let them help publicize and build a large-scale, professional and service-level elderly care service brand in Panzhihua City.
5.5. Diversified Elderly Care Services to Reduce Seasonal Impact
In response to the problem that the “migratory bird-style” elderly care service industry in Panzhihua is significantly affected by the season and difficult to operate, developers can reduce the off-season housing vacancy rate through diversified operating methods, but the diversified operating methods may reduce their professional services. Therefore, it is possible to consider the merger of multiple elderly care service industries to make the fund chain of developers in the elderly care service industry more secure, and expand diversified services while ensuring professional services. In this way, professional services can have a huge appeal to the elderly and win a better reputation; diversified services can also appropriately compensate for the operating losses of Panzhihua pension real estate in the off-season, and reduce the financial pressure of pension institutions.
6. Conclusion
With the changes in family structure and social progress, the elderly care service industry has developed rapidly, and emerging elderly care models such as migratory bird elderly care and combined medical care have gradually developed. These emerging elderly care models have been promoted in many regions. The characteristics of “migratory bird” pension under the background of the integration of medical care in Panzhihua City determine the seasonality of the pension model and the fixed round-trip time, which requires relatively high local medical and tourism services. At present, Panzhihua City still needs to improve many aspects of off-site elderly care services, and strive to ensure that the elderly can enjoy professional nursing care and rehabilitation training for some chronic diseases in addition to disease-free elderly care, health care, recreation and leisure and other elderly care services. Truly seamlessly connect the “combination of medical and nursing care” and the “migratory bird-style” elderly care service.