日本介护保险制度的发展及对我国居家养老服务的启示

日本为应对2050年即将出现的新一轮老人高峰,修订了介护保险制度内容,增加了居家护理服务内容并调整了相关费用。日本的居家护理服务较好地解决了现有的养老问题,对我国居家养老服务体系的构建和服务内容的完善提供了有益的借鉴。     

日本长期护理保险制度的运营现状与发展趋势

长期护理保险制度是日本社会养老保障体系的重要组成部分.本文运用厚生劳动省最新统计数据与调研报告系统分析了自2000年以来日本长期护理保险制度的运营状况.由于长期护理保险在运营过程中存在着一定的短板,目前日本政府正计划从构建更为紧密的医养结合型老年人护理服务体系、拓展服务内容更为丰富的“地域支援事业”等方面对长期护理保险制度进行改革.可以预见,覆盖范围更加广泛、内涵更加丰富、与其他社会保障制度衔接更为紧密的长期护理保险制度将在日本应对人口老龄化进程中发挥越发突出的作用.     

高度老龄化地区养老服务探索及发展策略研究--以天津市为例

人口老龄化加剧、社会经济发展转型与政府职能转变成为大力推动养老服务发展的客观要求。天津市已成为我国高度老龄化地区之一,在政府主导下初步形成了以社区居家养老和机构养老为主干的养老服务体系。但养老服务建设缺乏详细规划且管理机制尚未健全、养老服务事业的经费投入难以满足现实需求、区域间的养老服务资源非均等性明显、民办养老机构发展困难、专业养老护理人员缺乏等问题逐渐显现。未来时期应完善制度顶层设计和明确政府养老服务财政责任、促进养老服务管理标准化和加强行业监管、构建公办与民办养老机构差异化发展格局、促进养老服务人员的多元化与专业化、探索建立老年护理保险制度,从而推动养老服务健康发展。     

转型社会宗教参与养老的基础和优势研究

在我国社会转型时期,养老面临诸多现实困难。解决养老问题、提高养老质量需要宗教的社会支持。目前,宗教社会服务的相关政策环境不断得到改善,宗教参与养老发展空间广阔,具备了较好的社会基础;同时,宗教参与养老在改善养老环境、给予老年人精神支持和临终护理、组织开展各类慈善救助活动等方面也具有其他支持主体无法比拟的优势,因此,转型社会宗教参与养老具有可行性。     

城市社区养老服务质量评价--基于粗糙集方法的数据挖掘

客观公正的养老服务质量评价对完善社区养老体系建设有重要意义。本文基于粗糙集的研究方法,分别从生活照料、医疗护理、安全保障、精神慰藉以及社会参与五个维度对显著影响社区养老服务质量评价的指标进行了约简,进而确定质量评价体系的指标和权重,并对吉林市22个社区养老服务的质量进行了评价。结果显示,质量评价平均水平介于“一般”和“比较满意”之间;年龄越高的老年人对社区养老服务质量评价越低;社区养老建设试点小区的评分显著高于非试点小区。由此可见,我国社区养老试点建设已经取得明显成效,但亟须进一步推行和完善。     

我国养老护理保障制度的现状及展望

随着我国老龄化的加剧,养老护理问题日益突出。而家庭护理能力的下降,养老机构的不足,以社区服务为支撑的居家养老形式不失为一种好的选择。但是,居家养老也存在诸如资金不足,地区发展不平衡等问题。国家和政府对社区服务的更多介入,投资的增加,以及养老护理保险制度的引入势在必行。     

城市老年人对居家养老服务提供主体的选择及影响因素——基于福利多元主义视角的研究

居家养老是我国社会化养老服务的基础,诞生于西方发达国家的福利多元主义为我国国家主导型社会福利政策和居家养老服务的发展提供了理论资源。当前我国城市地区的居家养老服务主要依靠政府推动,市场化机制开始建立,老年群体对政府、社区依赖较高,对市场化服务供给主体的认可度仍有较大提升空间。加快发展居家养老服务,满足不同社会人口和经济特征老年人的多样化需求是一项社会系统工程。在创建多元化服务格局的过程中,需要政府、企业、社区、社会组织、志愿者、家庭和个人等各方参与主体明确权责,分工协作,扩大有效需求,统筹地区协调发展,凝聚推动供需两旺良性发展的合力。     

智慧社区养老服务体系构建研究

智慧社区养老是在我国人口老龄化加剧、机构养老服务问题凸显的情况下,在互联网+背景下提出的符合中国养老文化与习惯的新概念。本文探讨智慧社区养老服务体系构建原则、服务内容、服务载体及服务平台构成设计,指出智慧社区服务体系构建存在信息数据互联不畅,智慧社区养老服务平台顶层设计不规范,养老服务供需对接不到位,基层自治组织行政依附性较强等缺点,提出政府需搭建智慧社区养老服务平台推动信息共享,做好智慧社区养老服务平台顶层设计,智慧化解养老服务供需对接问题,改革社区管理制度等对策。     

日本和韩国老年长期护理保险制度比较研究北大核心CSSCI

在老年长期护理服务中,日本和韩国都选择了社会护理保险制度。从日韩两国护理保险制度实施背景来看,因老龄化的加速、家庭护理功能的弱化、既有制度的局限性、老年医疗费用的增加,两国都引入了护理保险制度,但两国的老龄化程度、基础设施等存在差异。从制度内容方面来看,虽然框架结构有些相似,但在具体表现形式上有些差异。两国的扩充护理机构、培养护理人员、扩大服务对象、加强预防事业等对中国开展老年长期护理服务具有重要的借鉴意义。     

日本护理保险制度述评

日本在 2 0 0 0年 4月 1日正式启用护理保险制度。这一制度把市町村政府定为保险主体 ,投保人为 4 0岁以上的日本人 ,参加这项保险为强制性或义务性。整个制度由个人每月所交保险费、中央和地方政府的资金以及每次使用服务时个人需交的一定费用支持。护理保险制度提供护理方面的服务分为居家护理和设施护理。在申请接受服务的程序通过后 ,适合于不同老人的帮助或护理方案成立 ,老人即可于 2 0 0 0年 4月 1日开始接受护理保险的服务。新护理保险制度与其他种类的保险不同 ,它强调老人的自主性 ,并有专门的人员提供护理服务 ,家务劳动和护理服务被数量化、货币化     

城乡社会救助体系建设与公共服务均等化

在和谐社会建设中,如何通过城乡统筹战略的实施构建覆盖城乡的社会救助体系．缩小城乡社会救助制度之间的差别,实现公共服务的均等化,已经成为社会救助体系建设所要解决的重要问题。本文从公共服务的视角．针对城乡社会救助标准差异过大的现实,提出城乡社会救助体系建设的途径,以实现公共服务的均等化。     

农村进城照顾孙辈的“候鸟式”老人在城生活状况调查——一项探索性研究

近年来，自农村进城照顾孙辈的“候鸟式”老人群体已颇具规模，因其流动性大、缺乏空间集聚性及无明确群体意识等特质，群体权益尚未引起各界关注。本文在呈现该群体的“照顾孩子及料理家务”、“闲暇时间及活动”、“与子女关系”、“与老家关系”等四个次领域生活场景的基础上，呼吁政府、社区及非营利组织给予其应有的关注及相应服务。     

生活满意度与养老院需求意愿的影响研究——江苏农村老年人的调查

在城镇化快速推进和家庭养老支持力弱化的背景下,农村老年人对养老院人住意愿也在发生变化。以人口老龄化严重、农村社会养老保险实现全覆盖的东部沿海经济发达省份江苏为例,运用Logistic旧归模型对农村老年人养老院的需求意愿进行实证分析。研究表明,农村老年人晚年生活满意度对养老院需求意愿存在负相关关系,即生活满意度低的老年人相比生活满意度高的老年人更倾向于选择入伟养老院。另外,农村老年人对养老院的需求意愿还受年龄、个人年收入、健康状况、存活儿子数和存活女儿数的影响。本研究的政策启示是,整合村组或社区中的多种力量,为农村老年人构建一个包含生活照料、精神慰藉等多方面的社会支持网络;科学预测农村人口老龄化水平和养老院的需求意愿,稳步推进农村地区养老机构事业发展;从农村地区实际出发,合理引导农村养老机构的资源配置和功能定位。     

印度私营医疗卫生服务体系的公平与效率

印度的全民免费公共医疗服务体系的公平性备受世界关注。本文分析了处于印度医疗卫生主体地位的私营医疗卫生服务体系的规模,着重从筹资水平、服务提供、费用支出以及监督管理等方面探讨了私营医疗卫生服务体系的运营和非营利私营医疗保险计划,重点研究了私营医疗卫生服务体系的公平与效率所在。旨在得出私营医疗卫生服务体系的公平与效率可以并行不悖的结论,为中国目前医疗卫生体制的改革提供有价值的借鉴。     

“社会养老”是否淡化了“子女责任”观念？--来自中国农村居民的经验证据

参保行为与养老观念存在双向因果关系,倾向于子女养老的居民参加养老保险的概率较低,而参加养老保险也改变着居民的养老观念。通过联立方程模型以及工具变量控制内生性后,得出了养老保险淡化“子女养老”观念的净效应,进而指出养老保险制度不仅挤出了子女对老人的经济支持,同时也弱化了人们的家庭养老观念。国家大力推行的养老保障体系在行为与观念两个层面上挤出了家庭养老,以国家制度化养老保障体系为主体的社会养老模式对家庭养老模式具有替代性。在养老模式的变迁中要综合考虑各主体的功能与责任,联合各界力量共同承担社会养老责任。     

Basic policies of the Philippine Population Program

This history of the Philippine Population Commission, which was created in 1969, is summarized. In 1970 President F.E. Marcos defined the government's task in this area as: 1) educating the people on the urgent need for population control; 2) disseminating knowledge on birth control techniques; and 3) providing facilities, especially in rural areas. Funding began in 1971. The 4 basic policies are noncoercion, integration, multiagency participation, and the partnership of the public and private sectors. The noncoercion policy means that all birth control techniques are offered and couples are free to use or reject whatever they wish. This has probably slowed the spread of family planning, but has also minimized opposition. Family planning has never been the domain of 1 agency but has been implemented through many agencies working together. Now it is being implemented through total community development plans, of which family planning is merely 1 component. This approach puts irrigation workers, agricultural development workers, and many others on the family planning team. private agencies have also had an important role to play in the development of the total program. For the past 5 years these have been mainly voluntary sociocivic and health associations whose interests are very close to or naturally related to family planning. Now the entry of business into the Population Program through the commercial contraceptive marketing program has enlarged the role of the private sector in the diffusion of family planning products and services. It is possible that the partnership between the public and private sectors may soon be based on segmentation of the target population with government agencies going deep into rural areas while private organizations concentrate on urban and adjacent rural areas.     

Inklusion durch Anerkennung

As common and plausible chronic diseases are for providing the rationale and relevance of preventive and rehabilitative interventions by the public health and nursing professions they do little to shape the every day practice and research of the health professions. Chronic diseases are often not treated as chronic but as either temporary crises or stable handicaps thereby ignoring the identity problems these people must contend with. While during the post 200 years respect for individual identity and approval for services have been kept distinct coping with the problems faced by those with chronic diseases have blurred the distinction between need for recognition and need for service. The blurring of the lines of distinction between need for recognition and the need for services is proven by a) the development of international standards of diagnoses and b) by the struggle of the welfare state against inequality in the face of chronic disease and death. This causes problems not only for the society but also for the chronically ill which should be analyzed within a theory of recognition.     

TOWARD A SUSTAINABLE US HEALTH POLICY: LOCAL CONGRUITIES AND GLOBAL INCONGRUITIES

The United States health care system is congruous with the US economy and with prevailing local values: it is resource intensive, technology-focused, consumer-oriented, individualistic, and unequally available. However, the US health system is incongruous not only with other health care systems around the world, but also with the increasingly global nature of health care concerns. Indeed the US system, according to the World Bank, stands out as strikingly expensive and ineffective in its public health impact. The article first identifies several significant incongruities, and then argues that there is an increasing obligation for the US health system to become more ethically responsive in light of global concerns. Sustainable health should be sought as a significant goal of US health services. Health services need to be fully and accurately assessed for their environmental costs, which need to be made explicit. Actual, universal access to basic health care services needs to take priority over scarce high-tech therapies when resource allocations are made. Traditional health values such as individualism, autonomy and privacy must be placed within a context of global interdependence and responsibilities to community. Public health fundamentals such as adequate nutrition, clear water, and a biologically intact ecosystem must be emphasized. Innovations in health technology need to be made with attention to their potential international use and impact. Finally, a longer time horizon for planning is needed, taking into account environmentally caused health problems arising fifty years or more in the future.     

Examining collaboration across organizations in an age-friendly community

ABSTRACT

Collaboration among organizations is fundamental to promoting age-friendly environments. This study questions: To what extent do organizations collaborate with other organizations in age-friendly communities to provide services to older adults? This study draws on 48 semi-structured qualitative interviews with representatives of organizations that provide services to older adults in an age-friendly community. Findings demonstrated that organizations can engage in collaboration and cooperation across multiple sectors of service delivery and across multiple types of organizations. Nevertheless, some organizations were not collaborating; older adults receiving services at these organizations may miss opportunities to connect to complementary services that can meet their holistic needs.     

新生代农民工住房状况影响因素分析：基于长沙市25个社区调查

运用长沙市25个社区994位新生代农民工的调查资料,采用因子分析方法获取住房状况总体评价系数作为因变量,通过路径分析法分析新生代农民工住房状况的影响因素。分析结果表明,当前新生代农民工住房状况总体较差,作为中间变量的社区环境和居住条件显著影响住房状况,社区环境因素是中间变量中影响力最大的因素。作为初始变量的收入状况、教育程度、婚姻状况、住房类型和工作行业不仅通过中间变量间接影响住房状况总体评价系数,而且对住房状况总体评价系数产生直接影响,作为初始变量的住房公积金对于新生代农民工的住房状况没有影响。最后建议强化社区公共服务制度的均等化,科学界定新生代农民工的住房保障对象标准,充分保障新生代农民工住房状况。