Based on the urban residents' basic medical insurance system in Qingdao,with hospitals,community aging care institutions and families as the carriers,Qingdao city explored and implemented the long-term medical care insurance system(LTMCI),and established mechanisms for fundraising,payment,handling,service and supervision.The city also designed a scientific application and reimbursement process.Three service modes are designed and put into practice as follows:Long-term care in designated nursing homes or pension institutions; Medical care at designated hospitals; and home health care.These services are charged by quota-lump per bed per day,with the reimbursement ratio of 96％,90％ and 96％ respectively.A practice over a year proved the LTMCI as effectively alleviating disease burden of patients,and guiding long-term care to serve communities.This way a new type of medical care system comes into being,with medicine-care-recovery-endowment for disabled population.

Objective:To construct and implement a multidisciplinary pain management model during the perioperative period based on the project-achieving quality control circle, so as to improve the quality of patient pain management during the perioperative period.Methods:Using the convenient sampling, 310 surgical patients from the Department of Gastrointestinal Surgery, Hepatobiliary Surgery, Thoracic Surgery, Urology Surgery and Joint Surgery of Liaocheng People's Hospital from June to July 2020 were taken as the pre-improvement group, and the routine perioperative pain management model was implemented. Starting from August 2020, a project-achieving quality control circle was carried out, following the steps of theme selection, topic clarification, goal setting, formulation of strategies, investigation of the best strategies, implementation of strategies, and confirmation of effectiveness, to implement a multidisciplinary pain management model during the perioperative period. A total of 310 surgical patients admitted to 5 departments from February to March 2021 were included in the improvement group.Results:The implementation rate of multidisciplinary pain management plan, the rate of out-of-bed activity within 24 hours after surgery, the rate of excellent postoperative rehabilitation compliance, and the average sleep score of patients in the improvement group all increased, with statistical differences ( P<0.05). After improvement, the awareness rate of pain knowledge among medical and nursing staff, the accuracy rate of nurses' rest and active pain assessment records, and the score of nurse pain knowledge all increased, and the differences were statistically significant ( P<0.05) . Conclusions:The construction and implementation of a multidisciplinary pain management model during the perioperative period based on the project-achieving quality control circle can effectively improve the quality of pain management for surgical patients, accelerate patient recovery, and improve the pain management of medical and nursing staff.