典型国家长期护理保险支付方式及启示

Payment Methods and Enlightenment of Long-Term Care Insurance in Typical Countries

美国长护险支付方式已由后付制转向预付制,德、日、韩则以按床日支付和按服务项目支付为主,支付标准日益精细化。我国长护险试点初期主要采用按床日支付和按服务项目支付,存在支付标准不能反映个体实际资源消耗、控费能力较弱等问题。对此,本文借鉴国外经验,提出建议:居家护理支付应转向预付制,支付标准要与护理需求相匹配,利用经济杠杆引导居家护理使用,并通过激励相容实现价值医疗。

The payment method of long-term care insurance in the United States has changed from post-payment to pre-payment,while Germany,Japan and South Korea mainly pay by bed-day and service items,and the payment standards are increasingly refined.In the early stage of long-term care insurance pilot projects in China,payment by bed-day and service-item was mainly adopted,and there were problems such as payment standards that could not reflect the actual resource consumption of individuals and weak ability to control expenses.It is suggested that home care payment should shift to a pre-payment system,payment standards should be matched with nursing needs,economic leverage should be used to guide the use of home care,and value medical care should be realized through incentive compatibility.