基于SD模型的我国长期护理保险筹资优化方案设计

Optimizd design of long-term care insurance financing scheme in China based on System Dynamics Simulation

目的:分析我国长期护理保险(以下简称“长护险”)基金的收支状况及其影响因素,预测长护险基金结余变化趋势,为我国构建基金可持续的长护险筹资机制提供优化方案与政策建议。方法:运用文献分析、现场调研等方法明确我国长护险基金收支现况及其主要影响因素,基于系统动力学(System Dynamics,SD)方法,建立长护险基金收支SD模型。结果:基于基金可持续原则,本研究共产生45种筹资组合方案,最终筛选出5种优化筹资方案。结论:为保障长护险制度的稳步推进和基金可持续运行,应尽快建立“独立型”长护险的筹资动态调整机制,适度提高个人缴费水平,加强老年人的失能干预,制定科学客观的失能评定标准,进而为我国各试点城市探索适宜的长护险筹资政策提供循证依据。

Objective:This study analyzes the balance between revenue and expenditure of long-term care insurance(LTCI)and its influencing factors,in order to predict the trend in balances of LTCI funds,so as to provide reference for an unified and sustainable financing mechanism of LTCI in China.Methods:Clarify current situation and its main influencing factors of supply and demand of LTCI funds with literature analysis and questionnaire survey,and establish a SD model for balance of LTCI.Results:This study produces 45 financing combination plans in accordance with the sustainability of funds.Five optimized plans are selected eventually under the criteria of the funds balance.Conclusions:A dynamic financing adjustment mechanism of LTCI is suggested to be established as soon as possible to steadily promote LTCI and sustainably operate funds.Individual payment rate is to increase appropriately,and disability intervention for the elderly is to be strengthened after the composition of a scientific and objective criteria for disability.Thus both the scale and sustain ability of the funds are maintained and the study becomes an example case for pilot cities seeking for suitable LTCI policies in China to refer to.