家庭灾难性照护支出:概念、测量与价值的初步探讨

Household Catastrophic Care Expenditures:A Preliminary Discussion of Concepts,Measurements and Values

在特定时段内,家庭照护费用支出在家庭可负担能力中的占比等于或超过一定的阈值,即表明家庭发生了灾难性照护支出。学术界尚缺乏关于家庭灾难性照护支出概念和测量的研究。本文参照医疗领域的灾难性卫生支出,构建并阐析家庭灾难性照护支出的概念和测量框架。其中,家庭照护费用包括因照护而发生的直接经济成本和间接机会成本,家庭可负担能力则综合考虑家庭的经济负担能力和照护负担能力。家庭灾难性照护支出的概念和框架提供了全面、整合的照护负担评估方法,纳入家庭照护者的机会成本,考虑应然状态下的照护需求,可作为更好的政策参考和识别标准。同时,对促进家庭照护回归、扩展和破解健康贫困、在相对贫困话语体系下重新认识政府在长期照护中的角色,也具有一定的积极意义。

In a specific period,if the proportion of family care expenditure in family affordability is equal to or exceeds a certain threshold,the family has catastrophic care expenditure.There is a lack of relevant research on the concept and measurement of household catastrophic care expenditure.Based on the calculation methods of catastrophic health expenditure in the medical field,this paper constructs and analyzes the concept and measurement framework of household catastrophic care expenditure.Family care costs include direct economic cost and indirect opportunity cost incurred due to care,and family affordability comprehensively considers family economic affordability and care affordability.The concept and framework of household catastrophic care expenditure which incorporates the opportunity cost of family caregivers and considers the care demand in the right state provide a comprehensive and integrated assessment method of care burden,and can be used as a better policy reference and identification standard.At the same time,it is also of positive significance to promote the return of family care,expand and crack health poverty,and re-understand the role of government in long-term care under the discourse system of relative poverty.