长期护理保险制度的评估框架及应用:基于三个案例的分析

An Assessment Framework for Long-term Care Insurance System and Its Application: Based on An Analysis of Three Cases

长期护理保险制度试点评估对于在全国建立长期护理保险制度具有重要意义。结合制度试点的两个指导意见,本文构建了一个针对长期护理保险制度的多层级评估框架,包含核心政策、管理建设和配套衔接等3项一级指标、10项二级指标和20项三级指标。应用该框架对青岛市、成都市和北京市石景山区三个典型试点地区的长期护理保险制度进行综合评估。评估结果表明,相较于成都市和北京市石景山区,青岛市的长期护理保险制度表现较优,同时三个地区的长期护理保险制度均存在改进空间。针对长期护理保险制度试点面临的问题和挑战,本文建议,做好制度顶层设计,处理好两个层面的政府和市场关系,把握好筹资水平与待遇标准等有关长期护理保险制度的五组关系,调整好居家护理、社区护理与机构护理等有关长期护理服务体系的三组关系。

Evaluating the long-term care insurance pilot program appropriately is of great significance for establishing a nationwide long-term care insurance system in China. This paper constructed a multi-layer assessment framework for the long-term care insurance system in accordance with two regulatory guidance papers on the relevant pilots. The assessment framework includes 3 layer-1 indicators,10 layer-2 indicators and 20 layer-3 indicators which fall under the categories of core policies,management system,and coordinating policies respectively. The paper applied this framework to evaluate three typical long-term care insurance pilot programs in Tsingtao City,Chengdu City,and Shijingshan District of Beijing,respectively. The results show that the long-term care insurance pilot program in Tsingtao performs best while pilot programs in Chengdu and Shijingshan District need to be improved. Given the problems and challenges faced by the long-term care insurance system,the paper suggests to focus on the top-level design,properly handle the relationship between the government and the market from two aspects,five key pairs of relationship on the long tem care system such as the relationship between the fund-raising standard and the compensation standard,and three groups of relationship regarding the long term care service system such as the relationship among home care,community care and institutional care.