照料社会化:长期照护保险制度实践研究——基于对青岛市长期医疗护理保险的考察

    Study on the Practical Implementation of Long-term Care Insurance System and the Social Care:A Case Research on Qingdao Long-term Care Nursing Insurance

    • 摘要: 以2016年国家人社部发布《人力资源社会保障部办公厅关于开展长期护理保险制度试点的指导意见》为契机,对青岛长期医疗护理保险制度进行重点考察,从社会照料转向的视角,着重探讨长期照护制度中政府、社区、家庭与市场等多元主体责任及其协同安排,并就中国长期照护保障体系的责任主体和模式选择的多元化、社会化提出相应对策建议:以目前青岛市的制度实践而言,存在制度基础、制度设计、制度执行等方面的实践限度;在医疗护理上,居家医护在4种医护形式中实际使用和业务结算均占比最高,居家安排仍是绝对主流;在生活照料上,家庭仍承担主要责任,但社会支持明显不足,严重缺乏家庭照护者支持政策,亟待长期照护保障体系向社会照料方面拓展。

       

      Abstract: Based on the "General Office of Ministry of Human Resources and Social Security Guidance on Pilot of Implementation of Long-term Care Insurance System" issued by MHRSS, PRC in 2016, this article explores the current situation and existing problems of Qingdao long-term nursing care insurance, gives an analytical explanation from the aspects of policy design, environment and implementation, and further discusses the division of responsibility and collaborative arrangement of the multiple welfare subjects amongst government, market, community, family and the individual, with putting forward the suggestions of, from the perspective of social care turn, the diversifying of responsibility subjects of LTC system and its modes as well. Research on Qingdao LTHC shows that, most of the LTC service are still provided within families (like informal caregivers) and at home (like LTHC), no matter whether it covered by the insurance or not; and the support to (formal and informal) caregivers and social care are obviously urgently needed.

       

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