老年照护需求评估体系的国内外比较与启示

Comparison of domestic and international elderly care needs assessment system and the implication

老年照护需求评估体系的建设有利于实现照护服务与老年人需求的合理匹配,促进养老资源的有效配置,是开展长期护理保险制度的基础与前提。“谁负责评估、对谁评估、用什么评估、评估费用如何支付”等问题是评估体系建设中需要明确回答的关键问题。从评估主体、评估对象、评估费用来源、评估维度等4个方面比较我国与荷兰、德国、日本、美国等典型国家的老年照护需求评估体系的现状:我国在评估机构的选择上交由第三方承担已成为趋势;与国外相比,国内评估人员的学科、专业背景较为单一;国外老年照护需求的评估对象更广泛,需求评估的法律与经费支持制度更成熟完善,评估维度也更客观全面。在此基础上,提出建立起全国统一的老年照护需求评估体系,培育专业的评估队伍,扩大需求评估对象的覆盖面,健全需求评估相关的法律保障与经费支持制度,建立多维度、科学的需求评估标准等方面的建议。

The construction of elderly care needs assessment system is conducive to realize the reasonable matching between care services and needs of the elderly,and to promote the effective allocation of pension resources. It is the basis and premise of the development of long-term care insurance system. Questions such as "Who is responsible for the assessment? Who can apply for the assessment? What is the assess tool? How to pay the assessment fee?" are the core issues that need to be addressed in the construction of the evaluation system. This study compared the current situation of the elderly care needs assessment systems in China,the Netherlands,Germany,Japan and the United States from four aspects:assessment subject,assessment object,assessment cost source,and assessment tools’ dimensions. It has been a trend to entrust a third party for the evaluation work in pilot cities in China. Compared with foreign countries,domestic appraisers’ discipline and professional background are simpler. In foreign countries,the evaluation objects of elderly care needs are more extensive;the legal and financial support system of needs evaluation is more mature;and the evaluation dimensions are more objective and comprehensive. Based on this study,we suggest China to establish a national unified elderly care needs assessment system,cultivate professional assessment teams,expand the coverage of care needs assessment objects,improve the standards of assessment objects and assessment dimensions,and improve the law and financial support regulations related to needs assessment.