长期护理保险制度可持续发展的日本镜鉴

Lessons from Japan's Long-term Care Insurance System in Terms of its Sustainable Development

随着我国人口老龄化的加剧,失能老人的护理问题越来越引起社会关注。日本早在2000年就建立了长期护理保险制度,为实现制度的可持续发展,日本政府在过去的20多年时间里推动了数次制度改革。系统研究其推动该制度可持续发展过程中的经验与教训,可为我国构建符合本国国情的长期护理保险制度带来有益参考,主要的经验包括:加强顶层设计,关注不同收入人群的可负担性;服务给付倾向居家养老,推行“去机构化”;重视预防在长期护理保险体系中的重要作用;推进基于社区层面的整合型照料;加强医护人才培养,形成跨学科联动机制。

With the acceleration of population ageing in China,the care of disabled elderly people has increasingly attracted social attention.Japan,a neighboring country of China in Asia,established a long-term care insurance system as early as 2000.It has been more than 20 years since the system was implemented.In order to achieve the sustainable development of the system,the Japanese government has promoted several reforms.Studying the experiences and lessons learned from the sustainable development of its system can provide a useful reference for China to build a long-term care insurance system that is in line with its national conditions.The main experiences and inspirations include:strengthening top-level design and paying attention to the affordability for different income groups;prioritizing home-based care services and promoting"deinstitutionalization";attaching importance to the important role of prevention service in the long-term care insurance system;promoting integrated care at the community level;and strengthening the training of medical personnel and forming a cross-disciplinary interaction mechanism.