根据《国务院办公厅转发卫生计生委等部门关于推进医疗卫生与养老服务相结合指导意见的通知》(国发[2015]84号)的要求，2017年5月杭州市江干区闸弄口街道通过街道家政服务、社区卫生服务中心和移动医疗三方签订协议，首次尝试开展医养结合日托型和居家型养老工作，将辖区内常住重点养老人员作为医养结合工作服务对象，流程如下：确立服务对象-签订三方合作协议-问卷调查-筛查评估-随访管理。由家政服务人员携带移动医疗仪器，在社区日间照料中心和上门检测养老人员血压、血糖情况，家庭医生每周在社区日间照料中心坐诊1次，提供医疗服务、健康宣教、心理疏导，并对每位老人的各项监测数据与现存的健康档案资料、门诊就诊信息资料进行匹配，通过筛查评估，制定个性化随访管理医疗服务。目前尚存在宣传不到位、居民不认可、医疗资源欠缺、专业人员不足、信息化欠完善等问题，难以高效满足养老人员服务需求，还需要政府、医疗机构、养老机构以及相关企业多方联动，力争全国范围推广，真正惠民。

According to the state council on forwarding health and family planning commission and other departments on promoting health and pension service combined with the guidance of the circular (guo fa [2015] no. 84), in May 2017, hangzhou jianggan district ZhaLongKou street by street housekeeping service, community health service centers and mobile medical tripartite agreement, for the first time, try to carry out medical combining work day care and home endowment, will be the permanent key pension personnel within their respective jurisdictions as medical combining work service object, the process is as follows: establish service object-the tripartite cooperation agreement-screening assessment-the questionnaire survey to follow-up management. By domestic service personnel carry mobile medical instruments, respectively in day care centers and community home testing pension personnel blood glucose, blood pressure family doctor visit in community day care center, 1 times a week to provide medical service, health education, psychological counseling, and the old man of each monitoring data and the existing health archives information matching, clinics, through the screening evaluation, formulate personalized follow-up management of medical service.The propaganda is not in place, the current residents not inadequate recognition, lack of medical resources, professional personnel, information inadequacy, difficult to efficiently satisfy the pension service demand, also needs the government, medical institutions, pension institutions and related enterprise linkage, strive to nationwide promotion, real people.