风险嵌入式需求溢出理论视角下的护理救助制度支付机制:德国的经验与启示

The payment mechanism of care assistance system from the perspective of Risk-embedded Need Spillover Theory: Experience and enlightenment from Germany

德国护理救助制度是长期护理保障体系整体支付的有机组成部分,作为“多元主体共担”最后一道防线,其支付机制精准识别个体溢出护理需求进而实现差异化兜底保障。本文在需求溢出理论的基础上结合学科特征对该理论纵深发展并提出“风险嵌入式需求溢出理论”,应用该理论分析德国长期护理救助制度支付机制实现差异化兜底保障的底层逻辑。研究发现,其支付机制从风险视角出发,细化家庭能力资源保障类型并实现对不同人群护理需求的差异化兜底保障。在健全护理保障体系的背景下,学习和借鉴德国的经验是应对我国护理保障不充分问题的有效途径。

The nursing care assistance system in Germany is an integral part of the overall payment of long-term care insurance,and as the last line of defense of"multiple subjects sharing",its payment mechanism accurately identifies individual overflow nursing care needs and provides differentiated guarantee.This study proposes the“risk-embedded need spillover theory”based on the need spillover theory and applies this theory to analyze how the payment mechanism of care assistance system in Germany provides differentiated guarantee,and found that the payment mechanism classified families’ability and resources from the perspective of risk.In the context of building a care protection system,learning Germany s experience is an effective way to cope with the problem of inadequate care protection in China.