In the face of an aging population, what are the "pain points" in the nursing industry?

Status of nursing services

1, the trend brought about by demographic changes, the demand for care is huge and continues to grow

According to the results of the Fourth Sample Survey on the Living Conditions of the Elderly in Urban and Rural China released by the Office of Aging in 2016, there are about 40.63 million disabled and semi-disabled elderly people in China, accounting for 18.3% of the total elderly population. In the next 20 years, the aging of China's population will become more severe. At the same time, with the implementation of the universal two-child policy, the infant and maternal ratio will be greatly increased.

The demand for medical services, especially nursing services, among the elderly, newborns and pregnant women is much higher than the population average, studies show that about 0.5% of people over 65 years of age need hospital treatment, about 2% need institutional care, and about 5% need community care.

In addition, the care needs of other groups are also being released at an accelerated pace, such as daily care of sub-health people, physiotherapy care and comprehensive recuperation, which is based on the care needs generated by improving the quality of life.

2, the shortage of professional nursing staff is huge

Compared with the huge demand for nursing services, China's existing professional nursing staff gap is huge, China's hospital bed to nurse ratio is 1∶0.27, the actual requirement is 1∶0.4, in the United States and other developed countries, the bed-to-nurse ratio has reached 1∶2 ratio. The increasing demand for social care, community care and home care will further increase the care gap.

In addition, the nursing service charge in China is only about 10% of the nursing cost, which is far lower than the actual human cost. Nursing is a typical modern service industry, involving both personal consumption services and public services, and these huge gaps mean new industrial opportunities.

3. Nursing technology and level need to be improved

In the medical service, there are "three medical treatment, seven nursing" concept, the current nursing mode of our country mainly has two kinds:

First, the hospital bed nursing, because there is no professional independent nursing institutions, when the need for care, there are repeated, intermittent occupation of comprehensive second and third hospital beds;

The second is family care, but the small family model and the huge expenditure of long-term care costs make it difficult to sustain, and family member care is not up to the quality of professional care, can not meet the needs of more advanced care. These two nursing methods can not meet the existing clinical nursing needs, let alone the needs of large nursing.

In addition, with the diversification of nursing needs and the rapid development of modern science and technology, a variety of high-tech technologies should also be combined with the characteristics of new nursing has been widely in-depth research and application, but the current nursing theory, means, technology is still relatively single, can not meet the rapid growth of needs.

4, the market gap is large, the service chain is fragmented

At present, the nursing in our country is mainly medical nursing, and nurses provide professional nursing services, lacking self-contained home nursing, and nursing staff are characterized by low education and low income. There is a huge gap in the market for professional care for disabled elderly people, infants, perinatal women, elderly care and high-end needs, and the service docking between various institutions is not smooth, and the care service undertaking outside the hospital is not smooth, and a perfect nursing industry has not been formed.

In short, the nursing industry is facing a single institution, the lack of equipment, the scarcity of practitioners, and the situation that the function has yet to be changed, which also means that the industrialization of nursing has a huge prospect.

Out-of-hospital nursing market is broad, enterprises have five development directions

Lin Yanglin, CEO of New Mileage Hospital Group, believes: "In addition to the nursing needs of hospitals, including community health and medical institutions, the combination of medical and nursing care, the nursing needs of the elderly, has not been standardized, standardized, and quality, from the perspective of the entire market, it is still focused on the technical role of nurses in the hospital."

In the out-of-hospital market, the care needs of more than 40 million disabled and semi-disabled elderly people have given the nursing industry a huge opportunity, as early as the Ministry of Civil Affairs issued in 2011, the "Twelfth Five-Year Plan for the construction of social pension service system (draft for comments)" has been mentioned. In 2020, the potential market size of China's elderly care services and life care will exceed 500 billion yuan.

However, at the same time, the proportion of aging population and chronic disease population is rising, and although the market outside the hospital is large, it also faces problems such as talent, business model and standardization.

Among the 31 care companies, 15 have received capital support, of which only 2 are located in the B round and later, the overall development of the industry is not mature, and the profit model is also being explored.

From the perspective of the direction of capital, the field of home care intersecting with the Internet is more popular, both because of its asset-light operation model, but also because of the current home-based care needs of "9073", that is, to the needs of the elderly as a breakthrough, combined with the Internet platform innovation service model, such as Xiaobai home care, Qingsongkang care, to carry out O2O home care and other businesses.

Since the payers of elderly care are not the elderly themselves, but their children, embracing the Internet has become an important way to broaden the service surface.

Observing the above enterprises, according to the different services and models they provide, they can be divided into the following four categories:

Home care

The number of disabled elderly in the home setting is large, but it is precisely this group that is furthest away from professional medical care. This model of elderly care service is the most "light", and the nurse home industry report published by the artery network also pointed out that medical staff provide medical services for the elderly at home, which may evolve into the key link of home care in the future.

For example, Qingsong health care, medical home, Xiaobo home care and other platforms are targeted at home scene nursing services, in the O2O model, to provide nursing staff, nurses home service.

In terms of the standardization of nursing, Xiaobo Home Care has established a unique door-to-door nursing process standard to maximize the control of risks in person-to-person services.

In the door-to-door elderly care enterprises, there are self-supporting service teams including Qingsongkang care (employee system and contract system are both), Xiaobo home care (all home nurses are employees of the company), and Ermaocare. The characteristics of such enterprises are that the service is more customized and standardized, and the positioning is also tilted to the middle and high-end.

Grassroots community care

The community care model, that is, day care centers, elderly care homes and other "doorstep" elderly care, can provide the elderly with basic services such as life care, rehabilitation physiotherapy, spiritual comfort and emergency assistance, as well as additional services such as entertainment, education and making friends.

With the gradual market-oriented development of elderly care, there have been various forms of model exploration, such as public-private partnership through PPP, government investment rental, and private construction community operation.

Among them, the government's operation subsidy support, or provide venues at low prices or even free of charge, so that the operator's assets are more "light". In the continuous exploration of the needs of the elderly, combined with door-to-door service, mutual assistance for the elderly, a variety of service platform operation and other resources, community care gradually bid farewell to the previous "do not make money" mindset.

For example, in cooperation with the Haidian District Government of Beijing, Youyouwanjia has built the first community embedded medical and nursing combination small old-age care institution - Youyouwanjia Old-age Care Center, Xueyuan Road, Haidian District, in Building 5 of Erlizhuang Community, and has operated two types of institutions, "community health service station" and "old-age care center", among which the community health service center is public and private. The elderly care center is operated independently to realize the elderly care and nursing of small and micro institutions in the community.

In addition to the elderly care services carried out by enterprises in the community, it also includes pilot practices based on community health service centers at the national level.

In July 2017, Anhui Province carried out the training practice of senior nurses at the grassroots level, selected senior nurses in hospitals, and went to community health service centers and township hospitals after training and qualification certification, invigorated nurse resources, and innovated urban medical union. The project was first piloted in Luyang District, Wuhu City and Bengbu City of Hefei.

Zhang Guangpeng, director of the human Resources Research Department of the Health Development Research Center of the National Health Commission, said that senior nurses to community centers mainly play several roles:

First, as a connection link of the medical union, promote the contact between the upper and lower institutions and institutions;

Second, for the grass-roots community health service center to do business guidance, "such as infection management, nursing management, grass-roots institutions, many community centers, the priority is not a large hospital specialist, but want to need infection management, nursing and other aspects of guidance and support."

The third is to set up specialized outpatient nursing services to provide specialized nursing services, focusing on providing comprehensive and continuous services around the elderly and high sugar, infants and pregnant women, three groups of people and four types of diseases.

It is one of the important practices to activate nursing resources for senior nurses to go to the grassroots level. In the case of the shortage of community nursing talents, senior nurses who can work without training provide professional technical support for primary nursing.

Institutional care/hospital care worker

From the perspective of the market size of hospital nursing, the nursing industry has a very large market. On the one hand, the rapid growth of domestic nursing demand and the long-term shortage of nursing investment, many hospitals "bed-to-nurse ratio" is not up to standard, and nurses are seriously insufficient. On the other hand, with the quickening pace of life, city residents can't spare time to accompany patients in hospitals.

The superposition of multiple factors has directly spawned the intermediate industrial chain - escort companies, and promoted the generation and development of the nursing industry.

In institutional care, institutions such as health care home, Youai Medical care, Tai Heart care, Afu Care mainly provide services for bedside care in hospitals, and provide in-hospital services through bidding, labor dispatch or O2O. Such nursing services are relative to patients and third parties outside the hospital. The reserve of talents and the development of standardization are also top priorities for such enterprises.

Nursing personnel training

This is a flow chart of factors of nursing services based on different models drawn by Arterial Network when taking stock of elderly care companies. From the chart, we can find that talent training is the upstream of the care industry, whether it is home care or institutional care, or person-to-person service in the final analysis. Therefore, for enterprises involved in nursing services, It is very important to build nursing talent team.

From the figure above, we can see that the talent training on the supply side is for all kinds of care enterprises, with the widest coverage.

At present, the third party service institutions mainly for the nursing industry include Nightingale, which specializes in cultivating elderly care talents, and the Network of Care, which aims at the training of the professional system of nurses.

Nursing industry is still not mature, talent training, primary care, home care ushered in opportunities

In the observation of the market, we found that talent training on the supply side, basic care with the widest coverage of the population, and home care fully integrated with the Internet have more opportunities to run ahead in this industry.

The demand for human skills provides opportunities for training

At present, it is in a new stage of the extension and extension of nursing connotation, and the new demand puts forward a test to the skills of nursing talents. Whether it is institutional nursing, home nursing, combination of medicine and nursing, hospice care, chronic disease management, nurses are an important professional service force, need nurses to master more skills, but also need all kinds of nursing talents to provide services, under such demand, nursing skills training institutions in the industry to usher in opportunities.

Among the various types of segmented talents involved in professional nursing services, including nurses, nursing staff, rehabilitation therapists, and health managers, nurses are the types of talents who provide the most professional nursing resources, so that they can provide professional support in other types of services and drive other nursing forces.

"The demand for nursing is very strong, there are many problems on the supply side, the solution to the problem is the incremental point, and the opportunity point is the mining of the stock," said Zhang Xueli, founder of the third-party nurse service platform.

For example, the value of senior nurses with 30% waste every year lies in their complete nursing skills, and this group of people has a high professional value growth point and value growth point. What the nurse training platform should do for them is to empower them, improve the effectiveness of nurses, and rationally allocate resources.

While helping nurses to complete their career planning, the Network of Nursing has developed six courses system training, in addition to the basic career path training content, it also covers health management training, special skills training, nursing management training and other courses to make nursing talents better in line with the market, and extend the career of nursing talents.

The demand of graded diagnosis and treatment brings opportunities for the development of primary care

Since the 1970s, quite a number of economically developed countries have begun to train corresponding nursing talents in traditional nursing colleges, and the cultural level of their community nursing staff is generally high.

From a comprehensive perspective, community care in the United States can be divided into the following three models:

A community care centre attached to an institution (affiliated educational institution, etc.);

② Community clinics or health clinics;

(3) Private community care centres opened and managed by healthcare entrepreneurs.

Nursing in the form of educational institutions has become one of the most important forms of community nursing in the United States, integrating teaching, scientific research and service properly. In many community health facilities in the United States, the number of nursing staff is as high as more than 80.00%.

The UK is the origin of community nursing, and the number of community nursing staff is increasing in the development process, which gradually emerged many new community nursing posts such as district nurses, school health nurses and health visiting nurses.

Under normal circumstances, nursing students can become formal nurses after passing the national medical qualification examination after graduation, but students who choose community nursing must have a one-year community nursing skills training on the basis of 3 years of basic nursing education, so that they can have a solid theoretical foundation and practical skills. Thus, I can quickly get started in the community nursing post and maximize the needs of community nursing work.

Japanese community caregivers are often referred to as health nurses. After obtaining the qualification of registered nurse, people engaged in health care professionals must also complete a specialized course in community nursing for a period of about 1 year, and also successfully pass the national unified examination in order to obtain the qualification certificate of health nurse.

According to statistics, in terms of school education, at the end of the last century, Japan has opened 65 medical colleges and universities.

In the current community nursing in our country, not only the comprehensive quality of community nursing staff is generally not high, and the number of corresponding posts is few, can not meet the needs of community nursing.

Therefore, China can learn from the foreign community nursing, add community nursing courses in the original medical courses, and constantly strengthen the practice; Set up targeted nursing training courses for community nurses.

In addition, excellent community nursing personnel can also be selected to go abroad to learn advanced community nursing technology and experience, in order to constantly speed up the training process of our country's community nursing personnel.

Home care, community care for the mainstream policy support, door-to-door care opportunities come

The elderly are the population with high incidence of chronic diseases and need better medical care services.

The "Several Opinions on Accelerating the Development of Elderly Care Services" issued by The State Council (Guofa [2013] No. 35) pointed out that "actively respond to the aging population, accelerate the development of elderly care services, actively promote the combination of medical and health care services as the main task, and do a good job in the prevention and treatment of chronic diseases of the elderly and rehabilitation care". Medical nursing service for the aged has become one of the most important services for the aged.

The situation of aging population will inevitably bring the present and future pension services in our country, especially the demand for pension medical and nursing services.