长期照护服务供给的国际趋势

International Comparison on Long-Term Care Provision

长期照护是西方发达国家二战后逐渐从养老服务和医疗服务中独立出来的一项社会服务。自引入长期照护服务后,各国的长期照护服务费用普遍经历了一个快速上涨的阶段,这其中人力成本增长带来的"成本病"尤为明显。为解决这一问题,西方各国除了引入外籍劳工外,一个重要的发展趋势是照护服务供给的非机构化,居家和社区照料供给占比不断上升。为解决政府直接供给带来的效率低下和费用高涨问题,自上世纪80年代以来,长期照护供给还出现了非政府化的趋势,政府直接供给转向政府向社会购买。

Long term care is a kind of social care emerged from aged care and medical care in developed countries after world war II （WWII）. Since it was initiated, most of the countries experienced a period of fast expenditure increasing, in which the labor force accounted for the major cost. In order to solve the problem of ＂high cost＂ of long term care, in addition to introducing foreign migrant workers, one of the important ways was to increase the proportion of home and community-based long term care rather than institutional care. To overcome the problem of low efficacy and high cost of government provision, since 1980s, the long term care showed a trend of non-governmental purchasing instead of government direct provision.