长期护理保险如何为中度失能老人提供保障——基于Barthel指数分析

How Does Long-term Care Insurance Provide Financial Protection for the Moderately Disabled Elderly——Analysis Based on Barthel Index

目的:基于长期护理保险试点扩大和实施进程不断深化的背景,探索为中度失能人员提供长期护理服务的有效路径。方法:借助中国健康与养老追踪调查2018年数据,使用Barthel指数评估老人失能情况。结果:(1)我国60岁以上老人中度失能率约为2.12%-2.95%,根据第七次人口普查数据测算,60岁以上中度失能老人约为559.7万人—778.8万人;(2)中度失能老人进食、穿衣、大小便控制、如厕、上下床等日常生活活动能力评分较高,洗澡、上下楼、平地行走等项目得分较低,在商店购买物品、做饭、做家务、洗澡这几项活动上有人帮助的比例分别是70.5%、69.5%、67%、68.1%;(3)大口径计算的中度失能老人慢病率约为29.4%,住院率为39%,CES-D抑郁评分15.027,存在中、重度抑郁情况。结论:建议逐步把中度失能老人纳入长期护理保险保障范围,通过政策引导中度失能老人选择经济上可负担性更高的居家护理服务。

Objective:Based on the background of the expansion and deepening of long-term care insurance pilots,the paper explores effective paths to provide long-term care services for moderately disabled individuals.Methods:This paper uses the data of China Health and Retirement Longitudinal Survey(CHARLS)in 2018 and Barthel index to evaluate the disability of the elderly.Results:(1)The moderate disability rate of elderly people aged over 60 in China is approximately 2.12%to 2.95%.According to the data from the 7th National Population Census,the number of moderate disability people aged over 60 is approximately 5.597 million to 7.788 million.(2)The moderately disabled elderly have higher scores on daily living activities such as eating,dressing,the defecation control,going to the toilet,and getting in and out of bed,and lower scores on bathing,going upstairs and downstairs,and walking on the ground.In addition,70.5%,69.5%,67%and 68.1%of the moderately disabled elderly were assisted in shopping in the stores,cooking,housework and bathing,respectively.(3)According to the large caliber calculation,the chronic disease prevalence rate of the moderately disabled elderly was 29.4%,the hospitalization rate was 39%,the CES-D depression score was 15.027,and there was moderate and severe depression.Conclusions:It is suggested to gradually include the moderately disabled elderly into the scope of long-term care insurance and guide the moderately disabled to choose more affordable home care services through policies.