目的: 系统分析数字技术赋能长期护理服务体系中多主体协同的机制、现存障碍及有效协同机制的构建路径。方法: 采用整合性综述方法,以“多主体协同”“长期护理”“数字技术”为核心,检索PubMed和Web of Science数据库,检索时限为建库日至2025年5月,通过制定纳入与排除标准筛选文献,最终纳入11篇符合要求的文献,采用主题分析法对文献数据进行提取与整合分析。结果: 数字技术视角下长期护理服务体系的多主体协同可分为实施维度与协同机制。实施维度涵盖信息流、工作流、多主体协同与体验、障碍与促进因素、机遇与挑战、建设路径;协同机制包括数字化平台构建和多主体对话机制。结论: 数字技术为长期护理服务体系的多主体协同提供了创新路径,但其效能发挥需要技术、组织与政策的协同配合。
Abstract
Objective: The paper systematically analyzes the mechanism of multi-agent collaboration enabled by digital technology in the long-term care service system, existing obstacles, and the construction path of an effective collaboration mechanism. Method: An integrative review method was employed to search the PubMed and Web of Science databases using the terms "multi-agent collaboration", "long-term care", and "digital technology", from the establishment of the databases to May 2025. We screened literature by establishing inclusion and exclusion criteria and 11 articles that met the requirements were ultimately included. The thematic analysis method was adopted to extract and integrate the literature data for analysis. Results: The multi-agent collaboration of long-term care service system from the perspective of digital technology can be divided into implementation dimensions and collaborative mechanisms. The implementation dimensions cover information flow, workflow, multi-agent collaboration and experience, obstacles and facilitating factors, opportunities and challenges, and construction paths. The collaborative mechanisms include the construction of a digital platform and a multi-agent dialogue mechanism. Conclusion: Digital technology offers an innovative path for multi-agent collaboration in long-term care service systems, but its effectiveness relies on the coordination of technology, organization, and policy.
关键词
长期护理 /
多主体协同 /
数字技术 /
国际经验
Key words
long-term care /
multi-agent collaboration /
digital technology /
international experience
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] World Health Organization. Ageing and health.[EB/OL]. (2024-10-01)[2025-04-18]. https://www.who.int/zh/news-room/fact-sheets/detail/ageing-and-health.
[2] 韩润霖,韩晓静,张立龙,等.中国农村失能老年人口的规模、结构与发展趋势——基于CLHLS数据和第七次全国人口普查数据的研究[J].人口研究,2023,47(02):63-77.
[3] 中华人民共和国民政部.民政部、全国老龄办发布《2024年度国家老龄事业发展公报》[EB/OL].(2025-07-24)[2025-08-14].https://www.mca.gov.cn/n152/n165/c1662004999980006089/part/21508.pdf.
[4] FENG Z L, GLINSKAYA E, CHEN H T, et al.Long-term care system for older adults in China: policy landscape, challenges, and future prospects[J]. Lancet, 2020, 396(10259):1362-1372.
[5] HE X L, WANG J L, LIANG Y.Developing integrated person-centered care quality indicators for home health agencies in Shanghai, China: a modified Delphi-analytic hierarchy process study[J]. Geriatric nursing, 2024, 58:1-7.
[6] 靳慧,赵明月,谢慧玲.中国商业长期护理保险发展现状分析[J].卫生经济研究,2024,41(4):51-55.
[7] 王雯,高紫璇.长护保险支持家庭非正式照护的国际经验与启示[J].中国医疗保险,2024(11):55-60.
[8] DEUSDAD B, DJURDJEVIC M, HALL K A E. Participation of older adults in the digital co-creation of long-term care services with the SoCaTel platform[J]. International journal of care and caring, 2024:1-21.
[9] KUOPPAKANGAS P, STENVALL J, KINDER T, et al.Detecting and managing the mechanism of perceived meaningfulness of work and digital transformation in public sector health and social care services[J]. Technological forecasting and social change, 2023.
[10] 杨思兰, 张杰, 李娟, 等. 整合性综述及其在国外护理领域的应用进展[J]. 解放军护理杂志, 2020, 37(7):54-57.
[11] ROST T B, CLAUSEN C, NYTRO O, et al.Local, early, and precise: designing a clinical decision support system for child and adolescent mental health services[J]. Frontiers in psychiatry, 2020, 11:564205.
[12] MONACO A, CASTEIG BLANCO A, COBAIN M, et al.The role of collaborative, multistakeholder partnerships in reshaping the health management of patients with noncommunicable diseases during and after the COVID-19 pandemic[J]. Aging clinical and experimental research, 2021, 33(10):2899-2907.
[13] TOLLEY C, SEYMOUR H, WATSON N, et al.Barriers and Opportunities for the Use of Digital Tools in Medicines Optimization Across the Interfaces of Care: Stakeholder Interviews in the United Kingdom[J]. JMIR medical informatics, 2023, 11:e42458.
[14] NABELSI V, PLOUFFE V.Enhancing care coordination in oncology and nononcology thoracic surgery care pathways through a digital health solution: mixed methods study[J]. JMIR formative research, 2024, 8:e60.
[15] LOMMI M, D’AGOSTINO F, ESPOSITO G, et al. Perception of utility and efficacy of implementation of TEC-MED model of care for frail older people and their caregivers: a qualitative study[J]. International journal of older people nursing, 2024, 19(6): e12658.
[16] DAS S, HUSSEY P.HL7-FHIR-Based ContSys Formal Ontology for Enabling Continuity of Care Data Interoperability[J]. Journal of personalized medicine, 2023, 13(7):1024.
[17] LIN G, LIN T K, ALLUHIDAN M, et al.Evidence for building an integrated dementia healthcare system: a systematic review[J]. Clinical gerontologist, 2025:1-17.
[18] KUEPER J K, TERRY A, BAHNIWAL R, et al.Connecting artificial intelligence and primary care challenges: findings from a multi stakeholder collaborative consultation[J]. BMJ health and care informatics, 2022, 29(1):e100493.
[19] PEEK S T M, WOUTERS E J M, LUIJKX K G, et al. What it takes to successfully implement technology for aging in place: focus groups with stakeholders[J]. Journal of medical internet research, 2016, 18(5): e98.
[20] RODOLFO I M S. Design strategy for integrated personal health records: improving the user experience of digital healthcare and wellbeing[D]. Lisbon: Universidade NOVA de Lisboa, 2017.
[21] GORDON A L, RAND S, CRELLIN E, et al. Piloting a minimum data set for older people living in care homes in England: a developmental study[J]. Age and ageing, 2025, 54(1): afaf001.
[22] Department of Health & Social Care. Data saves lives: reshapinghealth and socialcare withdata[EB/OL]. (2022-06-15)[2024-12-03]. https://www.gov.uk/government/publications/data-saves-lives-reshaping-health-and-social-care-with-data/data-saves-lives-reshaping-health-and-social-care-with-data.
[23] 国家发展改革委.国家发展改革委等部门关于印发《促进普惠养老服务高质量发展的若干措施》的通知[EB/OL].(2025-02-28)[2025-04-22].https://www.gov.cn/zhengce/zhengceku/202502/content_7008789.htm.
[24] MARWAHA J S, LANDMAN A B, BRAT G A, et al.Deploying digital health tools within large, complex health systems: key considerations for adoption and implementation[J]. NPJ digital medicine, 2022, 5(1):13.
[25] YU J, HUANG J, YANG Q.Long-term adoption or abandonment of smart technology in the Chinese elderly home care environment: a qualitative research study[J]. Healthcare, 2023, 11(17):2440.
基金
国家自然科学基金青年项目“基于数字照护生态系统理论的社区老人长期服务和支持的动力机制研究”（72304071）; 复旦大学—中国人民健康保险股份有限公司重大课题“长期护理保险服务体系中的多主体协同研究：基于数字技术的视角”（202413）; 复旦大学—复星护理科研基金面上项目“居家老人长期照护数字化方案的构建及应用研究”（FNF202356）
