乡村居家养老服务实践:分治与协同

Rural Home-Based Elderly Care Service Practice:Division and Collaboration

在全面推进乡村振兴背景下,政府购买养老项目扶持乡村公共服务,深化多主体协作,构建乡村养老联合体。依据供给主体不同,乡村社区居家养老服务项目分三类:“互联网+”公司主导的社区居家助老项目、医疗养护机构主导的家庭养老床位项目和社区治理面向的老年社工项目。借鉴网格治理理论,比较不同属性的供给主体在服务规划、服务体验和服务成效上的差异性,揭示项目制下主体分治产生异化的微观过程。目前此三者的服务供给面临三种困境:盈利组织服务低质化,混合型组织服务目标偏离,非盈利组织行政吸附、服务碎片化,最终三者走向服务“疏离化”和人员“内卷化”,根本原因在于政府边界模糊和各分治主体自主协调困难。建议根据生命周期,构建以家庭需求为本的协同机制,理清各主体彼此义务并创新流程,在新层面上发挥政府主导作用以重塑多主体合作关系。

Under the comprehensive rural revitalization context,the government will purchase elderly care projects to support rural public services,deepen multi-agent cooperation,and build a rural elderly care consortium.The current rural community home-based elderly care service projects are categorized into 3 types according to different supply subjects—community home-based elderly care projects led by"Internet plus"companies,home elderly care beds projects led by medical care institutions,and elderly social work projects oriented by community governance.Taking reference from the theory of grid governance,this study compares the differences in service planning,experience,and effectiveness among different attribute providers,and explains the micro process of subject differentiation under project-based governance.There are three dilemmas in service supply:profit making organizations are characterized by mechanical and low quality services,mixed organizations deviate from their goals and negotiate services,and non-profit organizations are characterized by administrative adsorption and fragmented services.Ultimately,the three are moving towards"alienation"of services and"internalization"of personnel,due to the blurring of government boundaries and difficulties in autonomous coordination among the main bodies.It is recommended to introduce the concept of life cycle,build a collaborative mechanism based on family needs,reintegrate multi subject participation,clarify mutual obligations and innovate processes,and leverage government leadership at a new level to reshape multi subject cooperative relationships.