制度视角下的城乡社区居家养老服务设施述评

A Review of Community Home Care Facilities in Urban and Rural Areas from the Perspective of System

构建居家社区机构"三位一体"的养老服务体系是我国应对人口老龄化的国家战略,其中社区是我国养老事业的重要依托,而目前面临着彼此功能定位不明的问题。文章以自上而下的视角,梳理我国养老服务体系的发展历程,结合社会背景概括我国居家养老服务设施从"机构-社区",从"保障-服务"的发展阶段;厘清社区养老服务设施的功能定位,归纳制度中"分级配置-服务对象-功能配建"的标准架构,研究考察相关政策、标准与规范,从制度视角将社区养老服务设施现状的主要问题进行拆解。社区居家养老是解决养老服务资源短缺与老年人照护需求之间矛盾的方式之一,提高社区活力与服务能力,整合既有社区养老空间物质资源,需要制度的自上而下引导。面对不同健康程度老人不同的照护需求以及城市农村老人不同的行为特征,需求是自下而上的推力,因此,社区居家养老服务设施的建设与设计仍需要业界学界的共同推进。

It is a national strategy for China to build a"trinity"old-age service system of home community institutions to deal with the aging of the population.The community is an important support for the old-age service in China,but currently faces the problem of unclear functional positioning of each other.From a top-down perspective,this paper combs the development process of China’s elderly care service system,and summarizes the development stages of home care service facilities in China from"institutions-community"to"security-service"in combination with social background.Clarify the functional positioning of community elderly care service facilities,conclude the standard framework of"hierarchical allocation-service objects-functional allocation"in the system,study and investigate relevant policies,standards and norms,and disassemble the main problems of the current situation of community elderly care service facilities from the institutional perspective.Community home care is one of the ways to solve the contradiction between the shortage of elderly care service resources and the elderly care needs.To improve community vitality and service capacity,integrate the existing material resources of community elderly care space,the top-down guidance of the system is needed.Faced with the different care needs of the elderly with different health degrees and the different behavioral characteristics of the elderly in urban and rural areas,the demand is the bottom-up thrust.Therefore,the construction and design of community home care facilities still need to be jointly promoted by the industry and academia.