老年护理保障需求、成本与筹资机制研究

In the next fifty years,our country is facing the problem of population aging. The ratio of total and partial disabled elders is on the increase. The issue of long term care for the elderly is becoming more and more serious with the family structure change and care cost rising. However, we have not established a sound long term care security system even now. And there is no consensus on what the system will be and how we set up the system in the academic and industry area. Especially,the study on the elderly disability and loss law, care cost and the financing mechanism is very scarce.This project will apply the Markov process to analyze the elderly disability loss distribution. We will find the law of disability state transfer and investigate service cost based of the micro-survey. The project then will bulid the care subsidy calculaition model and long term care insurance actuarial model. An estimation of care demand for the elderly next thirty years will be given accroding to the the sixth census data and the elderly longitudinal survey data.We will discuss the long term care system and financing mechanism with reference to the government responsibility, economic development level, social culture tradition and international experiences. Some policy suggestion will be given after we analyze the fesabilty of setting up the long term care subsidy and insurance system in our country.

未来半个世纪内，我国人口老龄化、高龄化趋势加剧，完全失能和部分失能老年人所占比重不断上升，加上家庭小型化和空巢化，老年人照料和护理将日益成为一个严重的社会问题。但是，目前我国还没有一套健全的护理保障体系。而且，对于建立怎样的护理保障体系，如何建设这套体系，学界和业界都还没有达成共识，尤其是关于老年人失能及其损失规律、老年护理成本和保障制度及其筹资机制的研究，更为缺乏。本项目拟运用马尔科夫过程研究老年失能损失分布，通过微观调查，研究老年人失能状态转移规律和护理服务成本；建立护理补贴测算模型和护理保险精算分析模型，运用人口"六普"数据和历次全国老年人状况追踪调查数据，研究未来30年我国老年人护理保障需求规模；根据政府老年保障服务职责、经济发展水平和社会文化传统，借鉴国际经验，探讨我国老年护理保障模式及其筹资机制，分析老年护理补贴制度和长期护理保险制度在我国建立的可行性，进而提出相应的政策建议

未来半个世纪内，我国人口老龄化、高龄化趋势加剧，失能老年人规模不断上升，加上家庭小型化和空巢化，老年人照护将日益成为一个严重的社会问题。但是，目前我国还没有一套健全的护理保障体系。而且，对于建立怎样的护理保障体系，如何建设这套体系，学界和业界都还没有达成共识，尤其是关于老年人失能率及其失能损失规律、老年护理成本和保障制度及其筹资机制这些基础科学问题的研究，更为缺乏。本项目综合运用了多状态生命表、马尔科夫过程等微观模拟方法与宏观模拟方法相结合，研究老年人失能率、失能损失分布，通过微观调查，进行了失能老年人需求评估和护理服务成本分析；建立护理补贴测算模型和护理保险精算分析模型，运用人口“六普”数据和历次全国老年人状况追踪调查数据，研究未来30 年我国老年人护理保障需求规模；根据政府老年保障服务职责、经济发展水平和社会文化传统，借鉴OECD国家等国际经验，探讨了我国老年护理保障模式及其筹资机制，分析了老年护理补贴制度和长期护理保险制度在我国建立的可行性及需要创造的条件，进而提出了相应的政策建议。这些建议受到国家民政部门、社会保险部门、财政部门的重视，并在有关老年护理和养老服务政策制定时得到应用。课题组成员还参与了全国性和浙江省长期护理保险政策的研究。