长期护理保险失能—照护等级评估制度区域比较研究——以长三角地区10个试点城市为例

伴随着我国长护险制度的逐步完善和全面推广,以及长三角一体化战略的纵深发展,未来长三角地区长护险制度将会面临更多的机遇和挑战.建立统一完善的长护险评估制度,对于保障社会民生、助推经济发展有着重要的战略意义.对此,应在制度调适及推广过程中更加聚焦于评估工作,以城市经济基础和社会保险制度为依托,探索区域共性、借鉴优秀经验,为长护险制度在长三角地区乃至全国范围内的完善、创新及推广提供一份借鉴.     

非失智、失能老年人的养老分析与研究

随着生活水平的提高,老年人的寿命也在延长,老年人养老问题成为了社会各界关注的焦点,如何在顺从老年人意愿的同时,又能保证养老需求,需要相关部门研究人员认真分析。本文从老人养老保障观念的分析出发,对非失智、失能的老人的养老问题进行了综合分析,旨在为相关管理人员提供有价值的参考建议。     

中国长期护理保险的理论依据、制度框架与关键机制

从面向贫困老年人的“兜底性”养老服务到覆盖全体老年人的长期护理保险试点,这是我国养老服务体制改革的开端。其中蕴含的风险基础、财政基础、理念基础、立法基础、经济基础、制度基础、社会基础以及技术基础是长期护理保险制度建立的理论依据。“十四五”时期是长期护理保险建设的重要“窗口期”,顶层设计应该考虑建立“1基9梁18柱”的制度框架,在长期护理保险制度建设发展过程中还需要特别注重均衡公平的筹资机制、服务基础的培育机制、智慧养老的信息化机制、与医疗卫生改革的协同机制以及制度运行的评估机制等五大关键机制建构。     

失能老人考验中国的社会安全网——中国失能老年人问题的解决之道

全球人口老龄化浪潮中最汹涌的洪峰是失能老年人口规模的迅速增长，也是国际社会普遍关注的重大问题。中国是世界上失能老年人口最多的国家，目前也是世界上唯一一个失能老年人口超过1000万的国家。2007年底，全国城乡失能老年人口为1350万，几乎相当于3个挪威的总人口。如果加上生活半自理老年人，大约3500万人，几乎相当于5个瑞士的总人口，已经凸显成为一个严峻的社会问题。     

中国发展长期机构看护及其社会影响的研究

这是对中国首都北京近来发展机构看护老年人情况所进行的一次调查。中国目前已有10％的人口达到了60岁或60岁以上，而65岁及65岁以上人口所占比例已达6．96％。预测显示，到2020年65岁及65岁以上人口将     

美国老年人长期照料的情况及政策

2011年8月2日。国家人口计生委、中国人口与发展研究中心举行“美国老年人的长期照料政策及研究介绍”学术讲座。这次讲座的嘉宾是美国布朗大学的冯占联博士。     

Affordable Clustered Housing-Care: A Category of Long-Term Care Options for the Elderly Poor

ABSTRACT

What we label as affordable clustered housing-care options are making it increasingly possible for poor and frail older Americans to age in place comfortably and securely in residential-like settings combining both affordable shelter and long-term care. The hallmark of these housing arrangements is their sizable population clusters of low-income frail persons in need of supportive services. Despite their greater availability and the compelling factors underlying their growth, the diversity of their supportive services and operations cloud their identity resulting in uncertainty as to whether they have a common mission. In response to the need for a more careful delineation of this aging in place option, this paper describes the distinguishing features of these hybrid settings and constructs a typology of their representative exemplars or prototypes.     

城市社区居家养老服务的发展思路与对策

随着老龄化时代的到来,需要照料的失能、半失能、失独老人总量不断增加,在当前传统家庭的养老功能不断弱化、机构养老服务能力滞后的形势下,居家养老服务模式成为解决养老问题的重大战略抉择。但目前居家养老服务总体而言尚处于起步和试点示范阶段,在居家养老服务资源凝聚、开拓,居家养老服务运作和软硬环境营造等方面,面临不少问题和困境,建议从资金、人力、设施、运作环境等方面来解决居家养老服务的发展问题。     

Future of Long-Term Care Financing for the Elderly in Korea

ABSTRACT

With rapid aging, change in family structure, and the increase in the labor participation of women, the demand for long-term care has been increasing in Korea. Inappropriate utilization of medical care by the elderly in health care institutions, such as social admissions, also puts a financial burden on the health insurance system. The widening gap between the need for long-term care and the capacity of welfare programs to fulfill that need, along with a rather new national pension scheme and the limited economic capacity of the elderly, calls for a new public financing mechanism to provide protection for a broader range of old people from the costs of long-term care. Many important decisions are yet to be made, although Korea is likely to introduce social insurance for long-term care rather than tax-based financing, following the tradition of social health insurance. Whether it should cover only the elderly long-term care or all types of long-term care including disability of all age groups will have a critical impact on social solidarity and the financial sustainability of the new long-term care insurance. Generosity of benefits or the level of out-of-pocket payment, the role of cash benefits, and the relation with health insurance scheme all should be taken into account in the design of a new financing scheme. Lack of care personnel and facilities is also a barrier to the implementation of public long-term care financing in Korea, and the implementation strategy needs to be carved out carefully.     

Predisposing,Enabling, and Need Predictors of Community versus Institutional Long-Term Care

Abstract

This research explored characteristics of the elderly that are associated with the use of long-term care services. Using the 1999 National Long Term Care Survey, logistic regression was employed to examine the relationship of race with the use of formal and informal long-term care. This study also examined the relationship of health insurance with the use of formal and informal long-term care. The Andersen Model on health services utilization was used as the theoretical framework. The findings indicated that race was not associated with the use of long-term care but rather with predisposing, enabling, and need variables. Health insurance was found to be associated with the use of long-term care even after controlling for predisposing enabling and need variables.     

Monitoring Quality of Care in Residential Care for the Elderly: The Information Challenge

This study assesses the administrative data compiled on residential care facilities for the elderly (RCFEs) by the state of California and considers the feasibility of their adaptation into a comprehensive information system. Required state RCFE reporting forms were reviewed for potential data elements. Recording and reporting variation was evaluated using a stratified probability sample of 340 facilities licensed in Northern and Central California. Stratification was by facility size and state district office. Data collection included a 5-year retrospective review of forms and documents in each facility's public file. Little of the information required from RCFEs is computerized. Most of it is maintained at the individual facility and not included in public files. Basic information, while included in the public file, is commonly either not available or not current. Resident characteristics and outcomes are not compiled, except indirectly in citations. The information required from RCFEs, if appropriately compiled and maintained, would produce a comprehensive quality assurance system and more effectively support consumer information and policy needs.     

湖南省解决农村贫困重度残疾人托养照护问题的实践与启示

解决农村贫困重度残疾人照护问题,既是党和政府的明确要求,也是残疾人和家属的热切期盼.湖南省农村贫困重度残疾人托养照护专项实践的主要启示:一是照护服务能有效改善农村重度残疾人生活质量和巩固脱贫攻坚成果;二是规划部署和经费配置是解决照顾问题的关键所在;三是"家庭自付+村社支持+政府补贴"的付费方式在实践中具有可行性和可持续性;四是农村地区需要优先发展保障急需的基本生活照护和寄宿照护服务,需要根据残疾人生活自理能力和家庭照护能力精准提供适合的照护服务.建议将"优先重点解决城乡低收入重度残疾人照护问题"纳入"十四五"规划及政府实事工程任务,加快建立以家庭照护为基础、社会化照护为支持、集中照护为补充的重度残疾人照护服务体系,完善以生活自理能力和家庭照护能力为核心指标的优先保障对象精准识别机制,通过"两补提标"、建立家庭照护和集中照护机构统一认定制度、评价制度和支持机制,完善残疾人帮扶机制.     

Distribution and Utilization of Home- and Community-Based Long-Term Care Services for the Elderly in North Carolina

ABSTRACT

Provision of home- and community-based long-term care is a growing concern at the national, state, and local levels. As more persons grow old, the need for these services is expected to rise. This analysis examines the distribution and utilization of three home- and community-based long-term care programs in North Carolina for each of the state's 100 counties. Maps were generated to examine how counties differed in respect to service utilization among the elderly. Great variability was found in number of elderly utilizing the services across the state as well as the percent of Medicaid- and/or age-eligible persons who utilized the programs. Multivariate modeling for associations to service utilization was only possible for one of the long-term care programs. Results indicated that living alone, being non-white, and having a mobility and self-care limitation were all positively related to utilization. Percent of persons 85 years or older and the ratio of institutionalized long-term care beds were negatively associated with utilization. It was concluded that states must engage in concerted efforts to ensure equity in access to home- and community-based long-term care.     

Beyond Being on Call: Time,Contingency, and Unpredictability Among Family Caregivers for the Elderly

This article explores contingency as a central yet underappreciated feature of care work. It does so by focusing on family elder care and the complex temporal interactions between caregiver, care receiver, and healthcare institutions in the U.S. context. Drawing on in‐depth interviews with 19 family caregivers for an elderly relative, I show that their experience of time is, paradoxically, systematically unpredictable. It is shaped by three dimensions: uncertain futures (not knowing how long, or how much, they will have to care), conflicting rhythms (mediating between the temporalities of institutions and that of the elderly relative), and flooded time (ongoing expectations of interruption). Focusing on caregivers’ experiences of unpredictability highlights their exclusion from broader social temporalities and the obstruction of their possibilities to craft their own futures. I therefore suggest that the experience and management of contingency may constitute its own form of inequality and is a fruitful site for exploring the temporal relations between paid and unpaid labor. Also, sociological theories of time and labor may benefit from foregrounding care work to advance understandings of the complex and hierarchical interactions between multiple temporal orders in post‐Fordist economies.