贵阳市长期护理保险筹资标准实证分析

An Empirical Analysis on the Financing Standard of Long-Term Care Insurance System in Guiyang

目的:计算并验证贵阳市长期护理保险制度的筹资标准,提出贵州省长期护理保险的筹资方案,为医保部门启动并实施长期护理保险提供理论依据。方法:通过运用国际劳工组织和国际社会保障协会推出的社会健康保险筹资模型的保险成本子模型,结合护理补偿费、失能鉴定费、运营管理费、风险储备金4个方面,计算筹资总额。结果:确定贵阳市启动长期护理保险的月投保费率为0.30%,与已成功实施长期护理保险的相关省市相比较,验证其筹资标准具有合理性和适当性。结论:提出贵州省长期护理保险的筹资方案:建议以城镇职工为参保对象,待条件成熟才能扩展到城乡居民;按“以收定支”原则筹资,实行比例缴费;多渠道筹资,加强缴费激励;匡算启动资金;对困难群体进行缴费援助;开展失能失智预防。给出长期护理保险筹资标准的理论算法和筹资机制,有利于降低欠发达地区启动长期护理保险的风险,提高基金筹资的科学性和稳健性。

Objective:To calculate and verify the financing standard of long-term care insurance system in Guiyang,propose the financial scheme and provide theoretical basis for medical insurance department.Methods:Combined with nursing compensation fee,disability identification fee,operation management fee and risk reserve,the insurance cost sub model of ILO model is applied to calculate the total amount of financing.Results:It is determined that the monthly premium rate of long-term care insurance in Guiyang is 0.30%.Compared with the relevant provinces and cities that have successfully implemented long-term care insurance,it was verified that its financing standard is reasonable and appropriate.Conclusion:It is suggested to take the urban employees as the subjects of the insurance,and the urban residents can be introduced on the condition of well preparation;raise funds based on the principle of income over expenditure",with proportional contributions;raise funds through multiple channels,and strengthen contribution incentives;converge the start-up funds;contribute the assistance for groups in need;and prevent of disability and dementia.It presents theoretical calculation and financing mechanism for long-term care financing criteria,which will help to reduce the risk of starting long-term care insurance in less developed regions and improve the scientific and robustness of fund funding.