失能老年人长期护理的需求规模评估、费用测算与经济效应预测

伴随着失能风险的增加,老年人长期护理问题成为人口老龄化研究的新课题.基于CHARLS等相关数据,改进Markov模型,测算2020—2060年失能老年人长期护理需求规模及费用,并预测经济效应,结果表明:(1)老年人数量呈倒"U"形增长趋势,并于2048年左右达到顶峰,约为4.34亿人;失能老年人呈逐年上升趋势,于2060年达到1.84亿人.(2)失能老年人长期护理费用由2020年的3906.57亿元增长到2060年的44973.16亿元,增长11.51倍,其中轻度、中度和重度失能老年人长期护理费用分别增长8.92倍、15.55倍和21.17倍.(3)老年护理劳动力需求量预测显示,由90.33万人上升到228.98万人,增长2.54倍;机构养老护理型床位需求量预测显示,由241.03万张增长到553.11万张,增长2.29倍;老年护理市场直接经济增量预测显示,由3906.57亿元增长到44973.16亿元,增长11.51倍.基于此,本文提出包括坚持"以制度为基础、以服务为核心、以救助为兜底、以法律为准绳"的基本原则,建立失能动态监控机制,完善养老服务财政补贴制度等政策建议.

Demand Scale Assessment,Cost Estimation and Economic Effect Prediction of Long-term Care for the Disabled Elderly

With the increased risk of disability,long-term care for the elderly has become a new research topic of population aging.Based on relevant data such as CHARLS,the Markov model was improved to estimate the scale and cost of longterm care needs for disabled elderly people from 2020 to 2060,and to predict the economic effect.The results showed that:(1)The elderly showed an inverted U-shaped growth trend,and reached the peak of 434 million around 2048;The disabled elderly are increasing year by year,reaching 184 million in 2060.(2)The cost of long-term care for disabled elderly people increased from 390.657 billion yuan in 2020 to 4.497316 billion yuan in 2060,an 11.51-fold increase;The long-term care cost of the elderly with mild,moderate and severe disabilities increased by 8.92 times,15.55 times and 21.17 times,respectively.(3)The labor demand for elderly care is predicted to increase from 903,300 to 2,289,800,an increase of 2.54 times;It is predicted that the demand for nursing beds in institutions will increase from 2.410,300 to 5.531,100,an increase of 2.29 times.It is also predicted that the direct economic increment of the elderly care market will increase from 390.657 billion yuan to 4497.316 billion yuan,an increase of 11.51 times.Based on this,this paper puts forward some policy suggestions,including adhering to the basic principles of“taking the system as the basis,taking the service as the core,taking the relief as the guarantee,and taking the law as the criterion”,establishing the dynamic monitoring mechanism of disability,and improving the financial subsidy system for the elderly service.