Core Insights - The article highlights the successful implementation of a "1+6+N" urban medical group framework in Tongliao City, which integrates various healthcare resources to provide high-quality medical services at the community level [1][4]. Group 1: Medical Reform and Structure - Tongliao City has established a "1+6+N" medical service framework, led by Tongliao People's Hospital, to address the uneven distribution of medical resources [1][4]. - The framework includes collaboration with Inner Mongolia University Affiliated Hospital and six grassroots medical institutions, creating a comprehensive medical community [1][4]. Group 2: Differentiated Services - Each of the six grassroots medical institutions specializes in different areas, such as traditional Chinese medicine, geriatric care, and rehabilitation, enhancing their service capabilities [2][3]. - The Chagan Health Center focuses on traditional Chinese medicine, while the Liaohe Health Center has established a palliative care model to improve the quality of life for terminal patients [2][3]. Group 3: Patient Benefits and Accessibility - Patients like a 3-year-old boy with autism and a 71-year-old esophageal cancer patient have benefited from specialized services, showcasing the positive impact of the medical reform [3]. - The establishment of a green channel for patient referrals has improved the efficiency of medical services, allowing for timely treatment and rehabilitation [4]. Group 4: Resource Allocation and Management - From January to October, 439 expert visits to grassroots institutions were recorded, along with the introduction of 23 new medical technologies [4][5]. - The focus on "small but beautiful" development allows each grassroots institution to excel in specific areas, enhancing overall healthcare delivery [5]. Group 5: Cost Efficiency and Quality Improvement - The integration of remote imaging and online consultation services has reduced the need for patients to travel for care, benefiting 2,848 individuals [5]. - The mutual recognition of 59 examination results within the group has saved patients a total of 112,000 yuan, demonstrating improved cost efficiency [5].

Core Viewpoint - The article emphasizes the urgent need for improved palliative care in China, highlighting that nearly 30,000 people die daily, which underscores the importance of making "good death" a public concern and accessible service for all [3][8]. Group 1: Current State of Palliative Care - Palliative care, also known as end-of-life care, aims to provide comfort and support to patients in the terminal stages of illness, focusing on symptom control and emotional support for both patients and families [4][5]. - The World Health Organization's principles of palliative care stress the importance of recognizing death as a normal process and providing relief from pain and discomfort without hastening or delaying death [5]. Group 2: Policy and Regulatory Framework - The Chinese government has initiated policies to promote palliative care, including the inclusion of palliative care centers in the medical institution directory, which marks a significant step in legal support for the industry [6][9]. - The "Healthy China" initiative has laid the groundwork for palliative care development, with specific guidelines and standards established for palliative care centers since 2017 [6][9]. Group 3: Challenges and Obstacles - Despite policy support, the quality of end-of-life care in China remains low, with issues such as inadequate pain management and lack of psychological support being prevalent [7][9]. - Payment mechanisms pose a significant challenge, as current reimbursement systems may not adequately cover palliative care services, affecting accessibility and sustainability [9][10]. Group 4: Future Directions and Opportunities - The recent national planning documents emphasize the need to enhance the care system for elderly individuals, including expanding palliative care services [11][12]. - The integration of palliative care into public health strategies is deemed necessary to address the growing demand due to an aging population and to fulfill ethical responsibilities [13]. Group 5: Company Initiatives - TaiKang has established a comprehensive palliative care model, providing multidisciplinary services across 10 facilities in 9 cities, with plans to expand to 15 facilities and increase bed capacity to nearly 150 by next year [14]. - The company focuses on a four-in-one model of palliative care, which includes comfort care, humanistic care, and grief therapy, with dedicated staff for each aspect, contrasting with the reliance on volunteers in many hospitals [14].

Core Viewpoint - The article emphasizes the importance of palliative care in improving the quality of life for terminally ill patients, highlighting its role as a public welfare initiative in China, especially in the context of the 20th National Congress of the Communist Party of China which advocates for enhancing people's livelihoods [1][2]. Group 1: Current Status of Palliative Care - Palliative care is not about "giving up treatment" but involves systematic relief of physical pain and psychological distress for terminal patients, focusing on improving their quality of life [3][4]. - As of now, palliative care services are rapidly developing in China, with various pilot programs initiated since 2017, and a growing number of hospitals establishing specialized palliative care units [3][4][6]. Group 2: Multidisciplinary Approach - A multidisciplinary approach is crucial for effective palliative care, involving pain management and understanding patients' emotional needs, with collaboration among medical professionals, social workers, and volunteers [4][6]. - Recent guidelines in Beijing have included medical social workers in core service teams, promoting shared decision-making between patients and families [4][7]. Group 3: Community and Home-Based Care - Community and home-based palliative care is increasingly recognized as essential, aligning with cultural values of dying at home and addressing practical needs [5][6]. - Innovative models are being explored, such as the integration of hospital, community, and family support systems to enhance palliative care accessibility [6][7]. Group 4: Challenges and Opportunities - There are significant challenges in palliative care, including uneven resource distribution, insufficient professional training, and a lack of standardized practices across regions [8][10]. - The demand for palliative care is expected to rise, with estimates suggesting that around 7 million patients annually require such services, yet only about 600,000 currently benefit [7][10]. Group 5: Future Directions - The establishment of industry standards and training programs for palliative care professionals is essential to improve service quality and accessibility [9][10]. - Ongoing efforts to develop comprehensive guidelines and training initiatives aim to enhance the skills of healthcare providers in palliative care [9][10].

Core Viewpoint - Shandong Province is actively enhancing its integrated medical and elderly care services to meet the growing health and wellness needs of its aging population, aiming to establish a comprehensive service system that is accessible and efficient [1][2]. Group 1: Development of Integrated Medical and Elderly Care Services - Shandong is constructing a service system that is urban-rural inclusive, appropriately scaled, functionally rational, and continuously integrated, focusing on improving service capabilities and levels [1]. - The province has selected 16 counties for a high-quality development innovation project in integrated medical and elderly care, providing each with 10 million yuan to encourage innovative support systems and service models [1][2]. - There are currently 1,125 integrated medical and elderly care institutions in Shandong, with a total of 330,000 beds available [2]. Group 2: Expansion of Medical Resources - The province is accelerating the establishment of elderly care hospitals, rehabilitation hospitals, and nursing homes, encouraging public medical institutions to add geriatric departments [2]. - 96.5% of secondary and higher public hospitals have established geriatric departments, and 96% of counties have at least one palliative care unit [2]. - Shandong is promoting the "two-institution integration" model, where medical institutions and elderly care facilities collaborate, resulting in over 5,000 service agreements between them [2]. Group 3: Focus on Cognitive Health - A comprehensive screening and follow-up model for dementia has been established, involving community health service centers and county-level medical institutions for initial screening and diagnosis [3]. - Approximately 60% of residents aged 65 and above in key counties have undergone cognitive function screening, indicating a proactive approach to managing cognitive health among the elderly [3].

Core Insights - The article highlights the urgent need for palliative care services in response to the aging population and the prevalence of chronic diseases among the elderly in China [1][2][3] Group 1: Palliative Care Development - The training session on palliative care was organized by the Bao'an District Health Bureau to enhance service capabilities and establish standards for palliative care units [1][2] - Professor Chen Yongyi discussed the integration of palliative care from policy to practice, addressing service norms, practical guidelines, and ethical considerations [2] Group 2: Institutional Developments - Five institutions in Bao'an District have been recognized as the first batch of palliative care service providers in Guangdong Province, part of a larger initiative involving 214 institutions across the province [3] - Bao'an District is implementing a three-tiered model of care that includes hospitals, community health organizations, and home care, with plans to develop palliative care units in three major hospitals by 2025 [3]

Core Viewpoint - The Guangdong Provincial Health Commission has officially announced the first batch of 214 palliative care institutions, achieving full coverage across all 21 cities in the province, aimed at enhancing the level of palliative care services [1] Group 1: Palliative Care Implementation - Palliative care focuses on terminally ill patients and their families, providing integrated care and humanistic support through multidisciplinary collaboration, helping patients to live their final days comfortably and with dignity [1] - By the end of 2024, the number of palliative care service institutions in Guangdong is expected to increase to 574, with over 5,000 palliative care beds, ensuring coverage across urban and rural areas [1] Group 2: Regulatory Framework and Guidelines - In July, the Guangdong Provincial Health Commission issued the "Guangdong Province Palliative Care Service Project Guidelines," detailing and standardizing 13 service items, including symptom assessment and survival period evaluation [1] - This guideline is the first provincial-level palliative care service guideline in the country, providing a comprehensive and precise "manual" for palliative care practices in the province [1] Group 3: Continuous Improvement Efforts - The notification emphasizes that health departments at all levels will enhance palliative care services through institution regulation, system construction, capacity building, and public awareness campaigns, ensuring quality care for every life’s final journey [1]

Core Viewpoint - Palliative care, particularly through the integration of medical social workers and volunteers, is evolving to provide more personalized and comprehensive support for patients and their families, enhancing the quality of life even in the final stages of life [1][8][10] Group 1: Development of Palliative Care - The implementation of the local standard "Palliative Care Service Specification" in Beijing in April 2025 emphasizes the inclusion of medical social workers in core service teams, promoting a collaborative model of care [1] - The palliative care team at Tsinghua University Beijing Tsinghua Changgung Hospital has evolved from specialized medical staff to a multidisciplinary collaboration, integrating social workers and volunteers for enhanced support [1][10] Group 2: Role of Medical Social Workers - Medical social workers are crucial in providing psychological support, repairing social relationships, and connecting families with community resources, thus facilitating personalized care approaches [1][8] - They play a vital role in addressing the emotional needs of both patients and families, helping them navigate the complexities of illness and end-of-life issues [8][9] Group 3: Volunteer Contributions - Volunteers are trained to provide various services, such as haircuts and music therapy, which significantly enhance the comfort and happiness of patients in palliative care [9] - The involvement of volunteers not only meets the practical needs of patients but also fosters a sense of community and support for both patients and their families [9] Group 4: Future of Palliative Care - There is an increasing demand for palliative care services, and the future will see an expansion of service areas, with community and home-based care becoming primary settings [10] - The development of more standards and guidelines based on practical experiences will aid in the training of palliative care professionals and improve service levels to meet diverse patient needs [10]

Core Insights - Dongguan's elderly population is projected to reach 416,088 by the end of 2024, accounting for 12.73% of the total registered population [1][4] - The highest aging rate is in Daojiao Town, where 19.56% of the population is aged 60 and above, followed by Zhongtang Town and Shilong Town at 19.48% and 18.85%, respectively [1][4] Population Statistics - As of the end of 2024, Dongguan's total registered population is 3,269,526, with 60 years and older individuals numbering 416,088 [4] - 26 towns have over 10% of their populations aged 60 and above, with Daojiao, Zhongtang, and Shilong leading [4] - Four towns have more than 20,000 individuals aged 60 and above: Guancheng (40,006), Humen (29,179), Houjie (22,558), and Dongcheng (20,636) [4] Elderly Welfare and Support - In 2024, 47.8% of the elderly population aged 70 and above receive high-age subsidies, totaling 199,000 individuals [7] - The subsidy standards are: 100 yuan/month for ages 70-79, 150 yuan/month for ages 80-89, 250 yuan/month for ages 90-99, and 550 yuan/month for those over 100 [7] - The total local government investment in the elderly care service system in 2024 is approximately 384.44 million yuan [8][11] Elderly Care Services - Dongguan has established 56 "Elderly Dining Halls" to provide meal services for elderly residents [9][11] - There are 47 elderly care institutions in total, with 5,493 beds available [11] - In 2024, over 15,000 individuals benefited from government-subsidized home care services, with 2.37 million home service orders placed [7][11] Legal and Medical Support - 26 medical institutions provide palliative care services, with 339 beds available for terminal patients [11] - Legal aid cases related to the elderly totaled 146, with 402 free will notarizations for first-time applicants aged 80 and above [11]

Group 1 - The core focus is on ensuring that the elderly population in Shenyang has access to medical care and support for aging, with a significant portion of the population being 60 years and older, approximately 2.34 million, which constitutes 30.6% of the total registered population [1] - Shenyang has established a comprehensive elderly health service system, with 83% of secondary and higher-level hospitals having set up geriatric medicine departments and 100% providing green channels for elderly patients [1] - The city has enhanced rehabilitation services, with 58 secondary and higher-level medical institutions setting up rehabilitation medicine departments and 40 offering rehabilitation outpatient services [1] Group 2 - Shenyang is actively promoting the integration of medical and elderly care services, with 27 institutions having "two certificates" for medical and elderly care integration by the end of 2024, and 280 elderly care institutions signing contracts with community health service centers [2] - A family doctor service network covers urban and rural areas, with 2,053 family doctor teams providing services to elderly individuals aged 65 and above, achieving a signing rate of 65.8% [2] - Initiatives to improve cognitive health among the elderly include the launch of an Alzheimer's prevention and treatment action, training 156 medical staff and volunteers, and screening 7,530 individuals for cognitive function [2] Group 3 - Shenyang plans to enhance elderly health services by introducing new oral health projects covering at least 300 communities and aims for 90% of secondary and higher public hospitals to have geriatric medicine departments [3] - The city will standardize cooperation agreements between medical and elderly care institutions, develop service quality assessment plans, and strengthen regulatory oversight of medical institutions within elderly care facilities [3] - For palliative care services, Shenyang will establish a quality standard system, add pilot institutions, implement professional talent training programs, and conduct strict service quality inspections to ensure high standards [3]

Core Viewpoint - The implementation of the local standard "Medical Institution Palliative Care Service Specification" in Beijing sets a new benchmark for the standardization of palliative care services across the country, addressing the growing demand for dignified end-of-life care in an aging society [1][2]. Group 1: Standardization and Implementation - The new standard establishes comprehensive guidelines from institutional qualifications to service processes, ensuring professional service delivery and patient comfort [2][3]. - It introduces a multi-disciplinary service model that includes not only medical staff but also rehabilitation and mental health professionals, enhancing the quality of care [2]. - The standard emphasizes a collaborative decision-making process involving patients and their families, restoring their rights to make informed choices at the end of life [2][3]. Group 2: Training and Resource Sharing - A three-dimensional implementation system has been created to promote the effective application of the standard, including training, collaboration, and iterative evaluation [3]. - The establishment of regional service alliances aims to facilitate resource sharing and mutual learning among healthcare providers [3]. - Continuous support through financial resources and talent development is being provided to ensure the high-quality development of palliative care services [3].