政策工具视角下中国长期护理保险政策的发展脉络与演进逻辑——基于310篇政策文本的内容分析(2012—2022)

Development and evolution logic of China s long-term care insurance policy from the perspective of policy tools:Content analysis based on 310 policy texts (2012-2022)

目的:为了提高系统评价的有效性,制定有效的老龄化策略,创建三维政策分析框架,讨论中国长期护理保险趋势和演进逻辑,为相关政策优化提供理论、方法和实证依据。方法:从政策工具视角出发,通过把政策工具、政策过程、政策主体有机结合,从三维立体角度建立研究框架,分析不同阶段的政策演进和政策作用。结果:目前我国政策变迁可分为三个阶段,其中政策推进阶段所发布的政策占比最高;长期护理保险的政策工具以供给型和环境型为主;政府机构中的保险经办、民政、医保、财政等部门以及非政府机构中的定点协议服务、评估、商业保险等机构是政策关注的重点。结论:(1)关注需求型政策工具,加强机构合作、政府购买服务等模式探索;(2)加强对长期护理需求人群的关注和政策保障;(3)加强政策学习,结合财政、医疗等相关政策共同推进长期护理保险政策发展。

Objective:To improve the effectiveness of systematic assessment,formulate effective aging strategies,the paper discusses the trend and evolution logic of China s long-term care insurance within a three-dimensional policy analysis framework,to provide theoretical,methodological and empirical reference for optimizing relevant policies.Methods:Analyze evolution and roles of policies at different stages from the perspective of policy tools,with a new research framework organically interwaving policy tools,policy processes and policy subjects.Results:So far development of China s policies can be divided into three stages,during the promotion stage of which the highest proportion of policies were issued;policies aiming at long-term care insurance feature mainly supply type and environment type;Insurance agencies,civil affairs departments,medical insurance departments,financial departments and fixed-point agreement service agencies,assessment agencies and commercial insurance agencies in non-governmental organizations are the emphases of the policy.Conclusion:(1)Focus on demand-based policy tools and service model explorations like strengthening institutional cooperation,government service purchase etc..(2)Pay more attention to people who need long-term care provide policy assurance to them.(3)Strengthen policy learning and promote the development of long-term care insurance policy in combination with financial,medical and other relevant policies.