英国长期照护:基本内容、改革取向及其对我国的启示

Long-term Care in England: The Contents,Reforms and Implications for China

有关中国长期照护模式的选择,国内多关注社会保险和商业保险模式,对英国的老年人照料模式关注不足。英国特有的制度设计理念能够为正在开展长期护理制度试点中的我国打开全新视野。与英国全民免费医疗体制不同,英国的长期照护制度以需求审核和家计调查为特点,具有社会救助的性质,资金主要来源于政府税收。在照护服务的提供方面,政府既对非正式照护提供一定的津贴补助,又通过机构照护和居家照护两大正式服务为老年人提供照料,其中使用社区居家照护的人数远高于机构照护。在人口老龄化趋势与财政开支吃紧的背景下,英国以整合照料为重点开始实施一系列提升绩效和优化服务的改革。英国的长期照护制度理念及改革实践可以给探索中的我国带来两点思考:一是如何合理界定中国长期护理保险的受益人群以实现社会公正;二是如何实现整合式照料,将医养康护、预防充分结合,提升长期照护效率,提高老年群体生活质量。

Concerning the choice of long - term care models, Chinese scholars have paid more attention to social insurance and commercial models than to the social care model in England. However, the unique philosophy of England＇ s long - term care can provide China, which is currently launching policy pilots, with a brand new field of vision. Different with National Health System in eligibility and means test. It has the feature of social England, the long- term care model is characterized by need assistance and it is mainly financed by general tax. In terms of service delivery, there are cash benefits and in - kind services. The formal care includes institutional care and home care ,and the number of people using home care is much larger than people using institutional care. Under the background of population ageing and tight finance, the British government has adopted a series of reform measures, focused on integrated care, to improve care performance and optimize service provision. This could intrigue deep thinking about China＇ s future policy - making： firstly, how to reasonably define beneficiaries of long - term care insurance to realize social justice in China; secondly, how to realize integrated care to promote efficiency of long - term care system and improve life quality of old aged people.