国内外长期护理保险需求评估的对比分析

Comparative study of the needs assessment of long-term care insurance at home and abroad

长期护理保险评估等级的认定是服务收费及保险赔付的基础,确保了服务提供的公平与效率。文章通过梳理国内长期护理保险(以下简称“长护险”)试点地区评估的相关政策文件以及国外评估的文献资料,对比研究发现:目前国内评估工具是以单一型的日常生活能力评定为主,而国外长期护理评估采用复合型评估工具开展更为全面的评估,秉持“以需求为导向”,处理“身体状态-照护服务”之间逻辑关系时通常会选用资源消耗量、标准护理时间等作为中介变量反映需求,这些做法应该为将来我国长护险评估的发展提供经验借鉴。

The determination of insurance assessment level in the long-term care insurance(LTCI) is the basis for service charges and insurance compensation,ensuring the fairness and efficiency of service provision.Through combing the relevant policy documents on the assessment of domestic LTCI in the pilot areas and the documentation of foreign assessments,the researchers found that :the current domestic assessment tool was mainly based on a single type of assessment focusing on daily living ability.The foreign long-term care(LTC) assessment used a comprehensive assessment tool to conduct a more comprehensive assessment,adhering to “demand-oriented” concept.When foreign LTC deals with the logical relationship between “the physical status and the caring services received”,it usually chooses resources consumption and standard nursing time as intermediate variables to reflect demand.The practice will provide experience for development of LTC evaluation in China.