日本护理等级评估标准制定方法与配套条件研究

Japan's Assessment Criteria for Grades of Care in Long-term Insurance:Methods of Formulating and Implementation Conditions

与国际上常用的根据失能状态划分护理等级的“日常生活活动能力量表(ADL)”和最小限数据集(MDS)相比,日本基于护理服务需求量划分护理等级的失能度评估标准,不仅解决了最小限数据集(MDS)不能根据评估结果判定服务申请者护理等级的难题,还达成了利用护理等级控制不合理的护理服务报酬之目的,并兼具适用于医疗、保健、康复领域之优势。而我国始于2016年的长期护理保险试点工作,出现了各地护理等级评估标准不统一问题,制约了规范公平的护理保险制度的建立。本文以评估调查的信息收集与分析为突破口,围绕评估指标设计、指标赋值法、“评估指标群”法和“树形图”法的内容,剖析日本护理等级评估标准制定方法与配套条件,为我国制定护理等级评估标准提供参考。

Instead of using the commonly used ADL and MDS, which group the grades of care by the degree of disability, Japan’s long-term care insurance groups the applicants’ grades of care based on their needs of care(standard time). This method not only solves the problem of the MDS being unable to classify the grades of the applicants based on the assessment results, but also contains unnecessary payment. Moreover, this assessment method can be applied to the fields of medical care, healthcare and rehabilitation. In China, the long-term care insurance pilot schemes starting from 2016 shows that the inconsistent assessment criteria for grouping the grades of care in different cities have hindered the establishment of a formal and fair care insurance system. To provide a reference for China, this paper analyses the methods of formulating and the implementation conditions of Japan’s assessment criteria for grades of care in long-term insurance.